肱骨经髁骨折

摘要

Objective To review the experience in management of transcondylar fracture of humerus in children.Methods Sixreen children,10 boys and 6 girls,with transcondylar fracture of humerus,were followed-up for 2 to 10 years.The fracture was categorised into type A(n=6),B(n=6)and C(n=4)according to Ddee's classification.Results Two patients were misdiagnosed as dislocation of elbow and one as fracture of the lateral condyle of the humerus.Clue reduction was carriod out in 12 patients with excellent results.Conclusions Delee type A fracture should be differentiated from dislocation of elbow.Close reduction is the treatment of choice.A line drawn along the long axis of radius.which usually passes through capitulum,is the key to diagnose type B and C fractures.The elbow should be fixed in flexed position with forearm pronated.This minimised cubitus varus deformity and displacement during immobilization.%目的 研究肱骨经髁骨折的诊断和治疗,以避免误诊和肘内翻发生.方法 报道16例肱骨经髁骨折,男10例,女6例.年龄从分娩第一天到7岁,平均3岁.结合文献资料进行回顾和分析.结果 本组2例误诊为肘关节脱位,1例误诊为肱骨外髁骨折,1例闭合复位失败改行切开复位.余均采用闭合复位.随访12例,随访时间2～10年,治疗效果良好.结论 Delee A型需和肘关节脱位鉴别,B型和C型由于肱骨小头骨化中心出现,小头和挠骨近侧的正常关系成为诊断的关键:笔者主张闭合复位,长臂石膏后托固定于屈肘,前臂旋前位,以维持复位,减少肘内翻.