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Two to 13% of supracondylar humerus fractures in children are associated with an ipsilateral forearm fracture, most of which are distal radius fractures. We present an unusual case of a 2-year-old girl with an ipsilateral supracondylar humerus fracture and a Monteggia lesion. Our management consisted of percutaneous K-wire fixation of the supracondylar humerus fracture and percutaneous insertion of an intramedullary K-wire for stabilization of the ulna fracture. Our patient had an excellent result, and we would recommend this method of fixation for similar injuries. 相似文献
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Closed reduction and percutaneous fixation of supracondylar fracture of the humerus and ipsilateral fracture of the forearm in children 总被引:1,自引:0,他引:1
Tabak AY Celebi L Muratli HH Murath HH Yağmurlu MF Aktekin CN Biçimoglu A 《The Journal of bone and joint surgery. British volume》2003,85(8):1169-1172
We treated 22 children with a supracondylar fracture of the humerus and an ipsilateral fracture of the forearm by closed reduction and percutaneous fixation. There were four Gartland type-II and 18 Gartland type-III supracondylar fractures of the humerus. There were fractures of both bones of the forearm in 16 and of the radius in six. Both the supracondylar and the distal forearm fractures were treated by closed reduction and percutaneous fixation. The mean follow-up time was 38.6 months. At the latest follow-up there were 21 excellent or good results and one fair result. There were no cases of delayed union, nonunion or malunion. Five nerve injuries were diagnosed on admission and all recovered spontaneously within eight weeks. No patient developed a compartment syndrome. 相似文献
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Sen RK Tripathy SK Kumar S Aggarwal S Tamuk T 《Journal of pediatric orthopedics. Part B》2011,20(3):129-137
Fifteen children with segmental forearm fractures were classified into two groups based on their proximal injury pattern. Proximal injury in group A was either Monteggia fractures or its variant and in group B it was diaphyseal fractures. The distal lesions in both these groups were either a metaphyseal fracture or an epiphyseal separation, or a combination of these two. Eleven children of group A were managed conservatively, whereas three of four children in group B required open reduction. After 2.67 years of follow-up in 13 children, clinical outcome based on modified Boyd and Boal's criteria was good in eight and fair in two children of group A, and good in two children and fair in one child of group B. The clinical outcome of pediatric segmental forearm fractures is good (P=0.05) and it may frequently need surgical intervention when the proximal fracture is diaphyseal. 相似文献
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G M Ter-Egiazarov B M Gorchiev V N Markulov I I Sanakoeva V T Stuzhina 《Vestnik khirurgii imeni I. I. Grekova》1988,140(6):89-93
The article analyzes results of treatment of 77 children with dislocations of the forearm bones complicated by a fracture of the internal epicondyle of the humeral bone. The method of operative treatment with the fixation of the epicondyle with the help of a screw-stylus which, while fixing the fragments, allows early development of movements in the elbow articulation. Long-term results were followed-up in 70% of the patients treated by this method. Timely diagnosis and operative treatment gave good results almost in all the patients. 相似文献
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An ipsilateral proximal humerus fracture, "flexion" supracondylar humerus fracture, and olecranon fracture found together is a rare event. The supracondylar fracture should be reduced and percutaneously pinned before the ipsilateral upper extremity fractures are reduced. Displaced supracondylar fractures should be pinned with crossed smooth pins. Most pediatric proximal humerus and olecranon fractures can be treated closed. 相似文献
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目的:制定儿童移位肱骨髁上骨折的规范化治疗方案,避免和减少并发症的发生。方法:对136例骨折中轻度肿胀的89例采用手法复位,失败的38例连同重度肿胀的42例采用骨牵引复位,牵引复位失败中的23例(10例拒绝手术治疗)连同陈旧性骨折的5例采用手术切开复位的三级筛选式治疗,并对其疗效进行分析评价。结果:手法复位成功51例,骨牵引后复位成功47例,手术切开复位成功28例。10例手法复位失败后拒绝手术治疗,后期发生肘内翻。随访136例,时间3~48个月,骨折均在3个月内愈合,肘内翻畸形26例,占19%。无筋膜间室综合征、伤口及针孔感染的发生。结论:三级筛选式治疗方案可明显提高肱骨髁上骨折的闭合复位成功率,降低手术率,避免和减少了并发症的发生,是一种理想的治疗手段。 相似文献
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肱骨髁上骨折是最常见的儿童肘部骨折,发生率占肘部骨折首位,多发生于10岁以下儿童,6~7岁为发病高峰,若处理不当常可导致肘内翻等并发症。对儿童肱骨髁上骨折的治疗,在强调选择最佳治疗方法使骨折断端解剖复位的同时,固定位置及外固定方法十分重要。目前治疗方法主要有整复外固定、闭合复位经皮穿针固定及切开复位内固定等方法。治疗的同时着重预防神经、血管损伤,Wolkmann缺血挛缩以及肘内翻等并发症的发生。本文主要对儿童肱骨髁上骨折并发症发生机制和防治进行了探讨。1早期并发症1·1神经损伤通常是神经失用,其发生率占肱骨髁上骨折的3… 相似文献
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Devnani AS 《Clinical orthopaedics and related research》2005,(431):36-41
In children with delayed presentation of displaced supracondylar fractures, closed or open reduction with K-wire fixation risks complications. Gradually reducing the fracture with traction potentially reduces these risks. An unacceptable deformity can be corrected later by an osteotomy. This concept was used for 28 children, with an average age of 7 years 6 months, who presented after an average delay of 5.6 days. Their stay in the hospital was 14 days on average. At followup (average, 24 months), five children (18%) who had cubitus varus greater than 10 degrees had corrective osteotomy. There were no additional neurovascular injuries after treatment. The results are comparable with other methods of treatment. 相似文献
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Factors affecting forearm compartment pressures in children with supracondylar fractures of the humerus 总被引:5,自引:0,他引:5
This study evaluated forearm compartment pressures in 29 children with supracondylar humerus fractures. Pressures were measured before and after reduction in the dorsal, superficial volar, and deep volar compartments at the proximal 1/6th and proximal 1/3rd forearm. Pressures in the deep volar compartment were significantly elevated compared with pressures in other compartments. There were also significantly higher pressures closer to the elbow within each compartment. Fracture reduction did not have a consistent immediate effect on pressures. The effect of elbow flexion on post-reduction pressures was also evaluated; flexion beyond 90 degrees produced significant pressure elevation. We conclude that forearm pressures after supracondylar fracture are greatest in the deep volar compartment and closer to the fracture site. Pressures greater than 30 mm Hg may exist without clinical evidence of compartment syndrome. To avoid unnecessary elevation of pressures, elbows should not be immobilized in >90 degrees of flexion after these injuries. 相似文献
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《中国矫形外科杂志》2016,(24):2269-2273
肱骨髁上骨折常发生于4~7岁儿童,约占儿童肘部骨折的70%,多因摔倒引起的传递暴力引起。目前,肱骨髁上骨折的临床治疗方法较多,但是无论何种治疗方法均无法完全避免肘内翻畸形的发生。肘内翻作为肱骨髁上骨折最常见的并发症,其发生率高达30%~60%,因此儿童肱骨髁上骨折的治疗也成为近年来骨科临床的难点和焦点。随着该疾病治疗方法的不断发展,并且近年来肘内翻矫形技术研究不断深入,有望逐渐降低肘内翻的发生率,减轻疾病并发症对患者关节功能和日常生活的影响,本文就近年来国内外对儿童肱骨髁上骨折的临床治疗和肘内翻的预防与治疗进展作一综述。 相似文献
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小儿肱骨髁上骨折肘内翻预防 总被引:9,自引:5,他引:4
目的:探讨小儿伸直型肱骨髁上骨折的治疗方法和防止肘内翻发生的有效措施。方法:伸直型小儿肱骨髁上骨折患者91例,其中男64例,女27例;年龄17个月~15岁,平均7.3岁;骨折类型全部为闭合性伸直型,桡偏型36例,尺偏型31例,旋转型24例。采用手法复位、曲肘前臂旋前位夹板固定治疗。结果:91例均获随访,随访时间3~36个月,平均19个月,参照李稔生等的疗效评定标准,优62例,良23例,可5例,差1例,优良率93.4%。肘内翻7例,占7.7%。结论:手法复位夹板固定是治疗小儿肱骨髁上骨折的常用方法,预防肘内翻的关键是正确的复位与合理的固定以及早期正确的X线评价。 相似文献
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<正>2011年1月~2012年12月,我科应用可吸收棒内固定治疗小儿肱骨髁上骨折32例,取得较满意疗效,报道如下。1材料与方法 1.1病例资料本组32例,男19例,女13例,年龄2~14岁。均为闭合明显移位的肱骨髁上骨折。受伤至手术时间1~10 d。伸直型29例,屈曲型3例。1.2治疗方法气管插管全身麻醉。行肘后正中纵向切口,从肘后肱三头肌 相似文献