[肱骨髁上骨折愈合不当: 以后会长出来的!]

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI:10.1007/s00113-024-01462-w
Ralf Kraus, Dorien Schneidmueller
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引用次数: 0

摘要

肱骨髁上骨折是生长期肘部最常见的骨折。发病高峰年龄在 5 岁左右。以伸展性骨折为主。临床诊断可通过两种投影的X光图像进行补充。与生长相关的创伤后畸形自发矫正很少发生。因此,治疗的目标是将每一个移位骨折积极转化为无移位的稳定固定骨折。如果治疗不成功,错位愈合的后果可能是,例如,由于残留的前屈或肘关节畸形而导致肘关节屈曲受限。合并症经常出现。原因包括缩小和保持的技术问题,也包括对X光检查结果的错误判断、对生长预后的无知或对是否达到治疗目标的验证不足。不满意的治疗结果应尽早纠正,主要是在骨愈合完成之前,其次是在以后的任何时间点进行矫正性截骨。矫正错位的时间越早,完全恢复到原来状态的机会就越大。根据畸形的类型和程度,文献中提出了多种矫正截骨技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Incorrectly healed supracondylar humerus fracture : That will grow out later on?!]

The supracondylar humerus fracture is the most frequent fracture of the elbow region during the growth period. The peak age is around 5 years. Extension fractures predominate. The clinical diagnostics are supplemented by X‑ray images in two projections. Growth-associated spontaneous corrections of posttraumatic deformities rarely occur. The goal of treatment is therefore the active transformation of every displaced fracture into a nondisplaced stably fixed fracture.If this is not successful, the consequences of healing in a malalignment can be, e.g., restriction of elbow flexion due to remaining antecurvation or cubitus varus. Combinations are often present. The causes include technical problems with reduction and retention but also misjudgement of the X‑ray findings, ignorance of the growth prognosis or inadequate verification of whether the treatment goal has been achieved.Unsatisfactory treatment results should be corrected as early as possible. This can be done primarily before bony healing is completed or secondarily as a corrective osteotomy at any later point in time. The earlier the correction of the malalignment is performed, the greater the chances of a complete restoration to the original condition. Depending on the type and extent of the deformity various techniques for corrective osteotomy are suggested in the literature.

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