Diagnosis and treatment of humeral medial epicondyle fracture combined with radial neck fracture in children and adolescents
10.3760/cma.j.cn115530-20221112-00566
- VernacularTitle:儿童及青少年肱骨内上髁合并桡骨颈骨折的诊疗分析
- Author:
Yunan LU
1
;
Ran LIN
;
Jiazhang WU
;
Jinchen CHEN
;
Tianlai CHEN
;
Yuling HUANG
;
Shunyou CHEN
Author Information
1. 福州市第二医院（厦门大学附属福州第二医院、福建医科大学第三临床医学院）小儿骨科，福建省创伤骨科急救与康复临床医学研究中心，福州 350007
- Keywords:
Children;
Adolescents;
Radius fractures;
Humeral medial epicondyle;
Radial neck
- From:
Chinese Journal of Orthopaedic Trauma
2023;25(2):142-146
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnosis and treatment of humeral medial epicondyle fracture combined with radial neck fracture in children and adolescents.Methods:The clinical data were retro-spectively analyzed of the 12 pediatric patients with fractures of the humeral medial epicondyle plus the radial neck who had been admitted from February 2015 to August 2021 to Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. There were 6 males and 6 females, with an age of (11.1 ± 2.5) years. According to the Papavasiliou classification, the humeral medial epicondyle fractures were type Ⅱ in 7 cases, type Ⅲ in 2 cases and type Ⅳ in 3 cases; according to the Judet classification, the radial neck fractures were type Ⅰ in 3 cases, type Ⅱ in 4 cases and type Ⅲ in 5 cases. Two Judet-Ⅰ radial neck fractures were missed by X-ray exam-ination but diagnosed by CT examination. Of the humeral medial epicondylar fractures, 9 were treated by open reduction and hollow screwing and 3 by closed reduction and Kirschner wiring. Of the radial neck fractures, 8 were treated by closed reduction and elastic intramedullary nailing and 4 conservatively. Fracture healing was followed up by postoperative radiographs. At the last follow-up, the carrying angles were measured, Kim Elbow Function Score (KEPS) was used to evaluate the functional recovery of the injured limb, and related complications were recorded.Results:All the 12 patients were followed up for (40.0±25.6) months. Fractures headed after (6.3±1.2) weeks. At the last follow-up, the carrying angle was 15.5°±2.6° on the injured side and 14.7°±2.0° on the healthy side, showing no significant difference ( P>0.05); KEPS was (96.3±5.3) points on the injured side and (98.8±2.3) points on the healthy side, showing no significant difference either ( P>0.05). No incision infection, bone nonunion, elbow valgus, joint stiffness or other complications were found; the postoperative elbow stability recovered well. Conclusions:As the fracture of the humeral medial epicondyle combined with the radial neck fracture is a special type of injury of straightened elbow during valgus stress in children and adolescents, it is likely to be missed in diagnosis. The goal of treatment is good functional recovery by restoring the articular match and elbow stability.
