Yuan Ganfeng,Liu Kun,Mei Haibo.Clinical analysis of primary distal humeral varus osteotomy plus internal fixation with bone grafting for old lateral condyle humeral fracture with elbow valgus[J].Journal of Clinical Pediatric Surgery,,19():825-829,857.[doi:10.3969/j.issn.1671-6353.2020.09.013]
Clinical analysis of primary distal humeral varus osteotomy plus internal fixation with bone grafting for old lateral condyle humeral fracture with elbow valgus
- CLC:
- R726.8;R681.7
- Abstract:
- Objective To explore the clinical efficacy of primary distal humeral varus osteotomy plus autogenous bone grafting and internal fixation for old lateral condyle humeral fracture with cubitus valgus deformity in children. Methods From January 2013 to January 2018,10 children with cubitus valgus deformity secondary to a nonunion of old humeral condylar fracture were treated.There were 8 boys and 2 girls with an average age of 10.5(5-14) years.The involved side was right (n=8) and left (n=2).The average age of injury was 6(3-10) years.The carrying angles were 20-40 degrees (n=8) and 40-50 degrees (n=2).Elbow joint functions were somewhat limited and 3 children developed ulnar nerve paralysis.Valgus angle of affected side and carrying angle of opposite side were measured preoperatively.All children underwent primary internal fixation with Kirschner wire for distal humeral varus osteotomy,autogenous bone grafting for old humeral lateral condyle fracture,hollow lag screwing and internal fixation of Kirschner wire.Follow-up observations were conducted postoperatively. Results During an average follow-up period of 22(12-60) months,all of them achieved bone healing.The average healing time of humeral osteotomy end was 7(5-12) weeks and the average healing time of fracture end of lateral humeral condyle 11.9(7-24) weeks.For 9 cases,extremity lifting angle was normal.One child had an extremity lifting angle of 20" and yet elbow joint function remained normal.The average range of motion of elbow joint at affected side was 92.5±20.8 pre-operation and 129.0±12.2 at 1 year post-operation.And the difference was statistically significant (t=7.639,P<0.001).The symptoms of ulnar nerve disappeared (n=3) and hollow tension screw rupture led to re-operation (n=1). Conclusion Primary distal humeral varus osteotomy,autogenous bone grafting for old lateral condyle humeral fracture,hollow lag screwing and internal fixation of Kirschner wire are efficacious for old lateral condyle humeral fracture with cubitus vagus deformity in children.The postoperative appearance,function and stability of elbow joint recover well so that second-stage operation is unnecessary.
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Memo
收稿日期:2019-11-02。
通讯作者:刘昆,Email:flydragon@126.com