手术治疗成人肱骨外髁骨折合并肘关节外侧脱位的疗效分析  

Surgical treatment of lateral condylar fracture of the humerus combined with lateral dislocation of the elbow in adults

作　　者：赵士君[1] 张威[1] 李翔[1] 孙若宾[1] 王爱国[1] Zhao Shijun;Zhang Wei;Li Xiang;Sun Ruobin;Wang Aiguo(Department of Orthopaedic Trauma,Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院创伤骨科,郑州450052

出　　处：《中华创伤骨科杂志》2024年第11期997-1001,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨成人肱骨外髁骨折合并肘关节外侧脱位的手术治疗策略。方法回顾性研究2020年6月至2023年6月郑州市骨科医院创伤骨科收治的8例成人肱骨外髁骨折合并肘关节外侧脱位患者。男3例,女5例;年龄(50.1±12.3)岁。所有患者均在消肿后行成人肱骨外髁骨折合并肘关节外侧脱位切开复位内固定术治疗。记录末次随访时肘关节屈伸和前臂旋转活动范围,采用Mayo肘关节功能评分(MEPS)评估功能恢复情况。结果2例患者整复后肘关节脱位恢复,但肱骨外髁移位未复位,肘关节仍存在半脱位;6例患者肘关节脱位手法复位后难以维持,肘关节仍处于脱位状态。术后随访时间12.0(12.0,18.8)个月。末次随访时屈伸活动度85.6°±20.3°,旋转活动度133.1°±24.0°,MEPS评分(91.9±8.0)分。8例患者关节稳定性较术前明显改善,均无明显疼痛,关节活动受限在可接受范围内。结论成人肱骨外髁骨折合并肘关节外侧脱位临床少见,手术治疗可获得满意的临床疗效,但也可能存在肘关节功能障碍以及患肢前臂旋转活动受限。ObjectiveTo explore the surgical treatment of lateral condylar fracture of the humerus combined with lateral dislocation of the elbow in adults.MethodsA retrospective study was conducted to analyze the 8 patients who had been treated at Department of Orthopaedic Trauma,Zhengzhou Orthopaedic Hospital for lateral condylar fracture of the humerus combined with lateral dislocation of the elbow from June 2020 to June 2023.There were 3 males and 5 females,with an age of(50.1±12.3)years.All the lateral condylar fractures of the humerus combined with lateral dislocations were treated by open reduction and internal fixation after swelling subsided.Flexion and extension of the elbow and rotation of the forearm were recorded at the last follow-up.Mayo elbow function score(MEPS)was used to evaluate the functional recovery of the elbow.ResultsElbow dislocation was corrected in 2 patients after rectification,but the elbow subluxation still existed because the displacement of the humeral lateral condyle was not reduced.The elbow dislocation still existed in 6 patients because it was difficult to maintain the correction of the dislocation after manual reduction.Follow-ups were conducted for 12.0(12.0,18.8)months.At the last follow-up,the flexion-extension was 85.6°±20.3°,rotation 133.1°±24.0°,and MEPS(91.9±8.0)points.The joint stability was significantly improved in the 8 patients compared with that before operation.Obvious pain was reported in none of the patients,and their joint limitation was acceptable.ConclusionsIn adults,lateral condylar fracture of the humerus combined with lateral dislocation of the elbow is rare in clinic.Surgical treatment of the condition can achieve satisfactory clinical outcomes,but elbow dysfunction and limited rotation of the forearm may occur in the affected limb.

关 键 词：肘关节 成年人 肱骨骨折 外侧脱位 手术 

分 类 号：R687.3[医药卫生—骨科学]