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中华肩肘外科电子杂志 ›› 2023, Vol. 11 ›› Issue (03) : 269 -272. doi: 10.3877/cma.j.issn.2095-5790.2023.03.011

病例报告

成人肱骨髁上骨折翻修一例
李康, 雷栓虎, 李延宏, 汪玉良, 刘京升()   
  1. 730030 兰州大学第二医院骨四病区
  • 收稿日期:2023-05-04 出版日期:2023-08-05
  • 通信作者: 刘京升
  • 基金资助:
    应用基础研究-面上项目(CY2020-MS07)
  • Received:2023-05-04 Published:2023-08-05
引用本文:

李康, 雷栓虎, 李延宏, 汪玉良, 刘京升. 成人肱骨髁上骨折翻修一例[J]. 中华肩肘外科电子杂志, 2023, 11(03): 269-272.

肱骨髁上骨折占所有成人骨折的0.5%~1%,肘部骨折的30%[1],其年龄和损伤机制呈现双峰分布,在年轻人中,由于高能量创伤而更常见,在老年人中由于低能量创伤而更常见[2]。其治疗以手术切开复位内固定治疗为主,以达到坚强固定及早期功能锻炼效果,手术治疗的优势在于可以为骨折断端提供更好的复位及力学环境,缩短了固定的时间,允许患者早期进行功能锻炼,减少肘关节功能障碍的发生,从而提高了患者的生活质量。正确的内固定选择非常重要,本科曾收治1例成人肱骨髁上骨折不愈合患者,经过翻修治疗后,疗效满意。

图1 当地医院术后复查影像学资料
图2 术后3个月影像学资料,肱骨内侧髁骨折移位,外侧髁钢板失效
图3 术后近2年影像学资料,肱骨内侧髁骨折断端吸收,断端硬化,肱骨远端前倾角增大
图4 肱骨内侧髁骨折断端吸收,断端硬化,内固定位置丢失,假关节形成
图5 本院翻修术后3 d摄片内外侧髁解剖恢复良好,内固定位置稳妥
图6 本院翻修术后3个月摄片见肱骨外侧髁骨折已有骨痂形成,骨折及内固定无移位
图7 本院翻修术后6个月摄片见肱骨内外髁骨折愈合良好,内固定位置无移位
图8 本院翻修术后6个月患者肘关节屈伸活动满意
图9 本院翻修术后12个月拍片见骨折线消失,骨折已愈合,内固定无移位
图10 本院翻修术后5年影像学资料(近期复查)见内固定已取出,肱骨远端解剖结构恢复大致正常
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