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目的通过改进后的治疗方法降低肘内翻的发生率。方法复位时使骨折端桡侧嵌插、尺侧分离,前臂屈曲旋前位固定,矫正尺偏及尺侧斜,以恢复骨折段正常轴线,尺轴型矫枉过正成轻度桡偏。需手术者,采用改进的后内侧手术入路,不切断肱三头肌。当尺侧骨皮质塌明显,复位后尺侧骨折端遗留间隙过大时,同时截除部分桡侧骨折端骨质,其截除高度相当于尺侧骨皮质塌陷的高度,并需术中测携带角,以防截除桡侧骨质过多造成肘外翻。判定复位优良的标准是恢复骨折段的正常轴线,不是骨折断端的局部对正、对齐。结果118例中79例得到15年随访,平均3.4年。通过摄肘关节标准正侧位X线片测量数据:CA角15.27°±3.81°,BA角28.41°±3.17°,肘内翻发生率3.43%。结论从生物力学及小儿肱骨髁上部解剖学观测角度,肘内翻发生虽有其客观因素,但治疗时只要彻底纠正尺偏倾斜并维持复位后的稳定,可使肘内翻发生率降至最低限度。
Objective To reduce the incidence of cubitus varus through the improved treatment. Methods The fracture was inserted into the radial side of the fracture, the ulnar side was separated, the anterior flexion of the forearm was fixed, the ulnar deviation was corrected and the ulnar oblique was restored to restore the normal axis of the fracture. The ulnar ulnar type was overcorrected into mild radial deviation. Need surgery, the use of improved posterior approach, do not cut off the triceps. When the ulnar cortical collapse obvious, after reset the ulnar fracture left excessive clearance, at the same time cut off part of the radial fracture bone, the height of its cut-off equivalent to the ulnar cortical collapse, and required intraoperative measurement Carrying the angle to prevent the removal of radial bone caused by excessive elbow valgus. Judge the fine reset is the normal axis of the fracture recovery section, not fracture local alignment, alignment. Results Among 118 cases, 79 cases were followed up for 15 years with an average of 3.4 years. According to the standard orthopedic X-ray measurement data of elbow joint, the CA angle was 15.27 ° ± 3.81 °, the BA angle was 28.41 ° ± 3.17 ° and the incidence of cubitus varus was 3.43%. Conclusions Biomechanics and pediatric supracondylar supracondylar anatomical view of the angle, although the occurrence of cubitus varus and its objective factors, but as long as the treatment of complete correction of tilt tilt and to maintain the stability of the reset, the varicocele can minimize the incidence of minimal limit.