新生儿肱骨远端骨骺分离的诊治体会  

Diagnosis and treatment of distal humeral epiphyseal separation in neonates

作　　者：何明哲[1] 孙一硕 张放[1] He Mingzhe;Sun Yishuo;Zhang Fang(Department of Orthopedics,Hebei Provincial Children s Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院骨一科,河北省石家庄市050031

出　　处：《临床小儿外科杂志》2018年第10期68-70,共3页Journal of Clinical Pediatric Surgery

基　　金：河北省医学科学研究重点课题(编号:20150570)

摘　　要：目的探讨新生儿肱骨远端骨骺分离的诊断及治疗策略。方法收集2015—2017年由河北省儿童医院收治的新生儿肱骨远端骨骺分离患儿5例,日龄分别为3 d 2例,5、6、10 d各1例。均排除化脓性感染,均行MRI检查,证实为肱骨远端骨骺分离。其中1例行切开复位克氏针内固定、石膏外固定,其余4例均行闭合复位、可塑性夹板外固定治疗。结果 1例因就诊时骨折断端已出现骨痂,术中闭合复位失败,遂行切开复位克氏针内固定、石膏外固定,其余4例均行闭合复位、可塑性夹板外固定。随访12～30个月,平均20个月,根据Mayo肘关节评分标准,其中4例为优,1例为良。结论新生儿肱骨远端骨骺分离易误诊,早期明确诊断需依靠MRI或超声检查,在治疗过程中,可靠及轻便的固定尤其重要。Objective To explore the diagnosis and treatment of distal humeral epiphyseal separation in neonates.Methods Five neonates of distal humeral epiphyseal separation were admitted from 2015 to 2017.The age was 3 days(n=2),5 days(n=1),6 days(n=1)and 10 days(n=1).Except for suppurative infection,all cases were examined by magnetic resonance imaging(MRI).One case underwent open reduction and internal fixation,the remainder had closed reduction and external splint fixation.Results One case of callus appeared at the end of fracture.After a failure of closed reduction,open reduction and internal fixation were performed subsequently.And the remainder had closed reduction.The average follow-up period was 20(12-30)months.According to the Mayo s elbow scoring standard,elbow function was excellent(n=4)and good(n=1).Conclusion Separation of distal humeral epiphysis is easily misdiagnosed in neonates.A definite diagnosis depends upon MRI or ultrasound.Reliable and light-weight fixation is vital for treatment.

关 键 词：骨骺 肱骨 新生儿 

分 类 号：R726.8[医药卫生—儿科]