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目的探讨儿童肱骨外髁骨折诊治及并发症的预防。方法701例Ⅰ型骨折进行保守治疗,673例保守治疗成功,28例5～15天发现骨片移位接受手术治疗;59例Ⅱ型骨折,2例保守治疗,49例手术治疗;62例Ⅲ型Ⅳ型骨折,8例陈旧性骨折病例手术治疗,总共147例手术;12例放弃治疗。结果保守治疗的骨折病例中,1例Ⅱ型骨折病例出现肘内翻;139例急性亚急性手术病例,22例轻度肱骨外髁隆凸,5例轻度肘关节功能受限,1例肱骨小头及滑车坏死,1例内固定感染骨髓炎;8例手术治疗的陈旧性病例,5例效果满意,2例肘关节功能受限,1例骨不连。结论儿童肱骨外髁骨折治疗的关键是争取早期解剖复位,防止陈旧性骨折的发生。
Objective To investigate the diagnosis and treatment of condylar humerus fractures in children and the prevention of complications. Methods A total of 701 fractures of type Ⅰ were treated conservatively, 673 cases were conservatively treated, 28 cases were treated by surgical removal of bone chips in 5 to 15 days, 59 cases of type Ⅱ fractures, 2 cases of conservative treatment and 49 cases of surgical treatment. 62 cases of Ⅲ Type Ⅳ fractures, 8 cases of old fracture surgery, a total of 147 cases of surgery; 12 patients give up treatment. Results Of the conservative treatment of fracture cases, 1 case of type Ⅱ fracture had cubitus varus; 139 cases of acute subacute surgery, 22 cases of mild humeral condyle bulge, 5 cases of mild elbow joint function limitation, 1 case of humerus One patient had osteonecrosis of the intestine, one patient had osteonecrosis of the intestine, eight patients had old cases treated satisfactorily, five patients were satisfied, two patients had limited elbow function, and one patient had nonunion. Conclusion The key to the treatment of fractures of the humeral condyles in children is to seek early anatomic reduction and prevent the occurrence of old fractures.