C型臂辅助下微创手术治疗儿童肱骨小头冠状面骨折

目的：探讨在C型臂辅助下对儿童肱骨小头冠状面骨折进行微创手术治疗的临床疗效。方法：2003年1月至2013年6月共收治28例有移位的肱骨小头冠状面骨折患儿，男15例，女13例，年龄8～14岁，平均10.3岁。所有患儿在C型臂X线机监控下使用经肘外侧入路小切口（＜2 cm）骨折复位空心螺钉后前位内固定的微创手术方法进行治疗，术后采用Mayo肘关节评分标准对患者肘关节的疼痛、活动范围以及功能进行评估。结果：所有患儿术后随访7～36个月（平均24.2个月）。根据Mayo肘关节评分标准，最低分为80分，最高分为100分，平均得分92.5分，其中优20例，良8例，优良率100%。所有患儿均达到骨折临床愈合标准，未发现肱骨小头缺血性坏死及异位骨化等并发症。结论：C型臂X线机辅助下经肘外侧入路小切口（＜2 cm）骨折复位空心螺钉后前位内固定的微创手术治疗儿童肱骨小头冠状面骨折具有手术创伤小，固定牢靠，操作简便及并发症少的特点，是一种治疗儿童肱骨小头冠状面骨折的理想方法。

Minimal invasive treatment of coronal plane fracture of the capitellum humeri of teenagers with the help of C-arm X-ray machine

Objective: To evaluate the clinical outcome of teenagers’ coronal plane fracture of the capitellum humeri treated with minimal invasive treatment with the help of C-arm X-ray machine. Methods: Twenty-eight teenagers with coronal plane fracture of the capitellum humeri were collected from January 2003 to June 2013, among them 15 were male and 13 were female, age ranged from 8 to 14, average age was 10.3. All patients underwent open reduction and internal fixation using compressive hollow screws inserted in a posterior-to-anterior direction with the help of C-arm X-ray machine. Elbow pain, range of motion, stability and function were evaluated using the Mayo Elbow Performance Index after surgery. Results: The mean follow-up period was 24.2 months (ranged 7-36 months). The mean Mayo Elbow Performance Index score was 92.5 (range 80-100) and the scores were excellent in 20 cases and general in 8 cases. All patients achieved anatomic bone union and no patient developed avascular necrosis or heterotrophic ossification. Conclusion: Teenagers’ coronal plane fracture of the capitellum humeri treated with minimal invasive treatment with the help of C-arm X-ray machine have the advantages of minimal invasion, firm fixation, easy to operate and fewer complications, which can achieve excellent clinical outcome.