临床小儿外科杂志2024，Vol.23Issue(3)：254-257,4.DOI:10.3760/cma.j.cn101785-202301007-010
切开复位后方加压埋头钉固定治疗儿童肱骨小头骨折疗效评价
Outcomes of posterior open reduction plus internal fixation of capitellar fractures in children
摘要
Abstract
Objective To explore the efficacy of open reduction plus internal fixation with compression screws for pediatric capitellum fracture.Methods From December 2018 to January 2022,the relevant clinical data were retrospectively reviewed for 14 children hospitalized with coronal capitellum fracture.There were 13 boys and 1 girl with an average age of(13.47±1.31)(10-15)year.The involved side was left(n=10)and right(n=4).The time from injury to operation was(2.61±1.32)day.Imaging studies of computed tomo-graphy(CT)and three-dimensional reconstruction pre-operation were examined.According to the Bryan Morrey classification scheme,the clinical types were Ⅰ(n=8)and Ⅳ(n=6).According to the criteria of Boston Children's Hospital,all fractures belonged to coronal shear type Ⅰ b.Open reduction was performed via Kocher approach and compression screw fixation.Elbow function was evaluated by Mayo and Quick DASH standards.At the last follow-up,healing,appearance,necrosis,smoothness of articular surface and osteoarthritis of capitellum fracture were evaluated by radiography.Results The perioperative parameters were intraoperative volume of blood loss(36.67±15.60)ml,fluoroscopic frequency(9.32±5.37),incision length(5.54±1.93)cm,hospitalization stay(7.06±2.45)day and operative duration(64.38±12.84)min.During an average follow-up period of(31.04±4.05)month,there was no occurrence of infection,internal fixation loosening or plaster pressure sore.Mayo score of elbow joint was(94.62±3.31)point.At the last follow-up,there were smooth ar-ticular surface and normal anatomy of capitellum.There was no onset of nonunion,necrosis of capitellum hu-meri,osteoarthritis or joint function limitation.Conclusions Early open reduction plus compression counter-sunk nail internal fixation of coronary shear capitellum fracture is mini-invasive with minimal injury to articular cartilage.With rapid functional recovery,it offers excellent short-term outcomes.关键词
肱骨小头/骨折/外科手术/儿童Key words
Capitulum Humerus/Fracture/Surgical Procedures,Operative/Child引用本文复制引用
姚杰,申向阳,贾国强..切开复位后方加压埋头钉固定治疗儿童肱骨小头骨折疗效评价[J].临床小儿外科杂志,2024,23(3):254-257,4.基金项目
国家自然科学基金面上项目(61976008) （61976008）
安徽医科大学基金项目(2022xkj111) National Natural Science Foundation of China(61976008) （2022xkj111）
Institutional Project of Anhui Medical University(2022xkj111) （2022xkj111）
