儿童桡骨颈骨折治疗PPT课件

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Advantage of ESIN
minimally invasive technique stable fixation early mobilization anatomical reduction lower complication rate good-to-excellent results
• The proximal radial epiphysis is mainly supplied by periosteal blood vessels running from distal to proximal.
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Mechanism’
• 2 main mechanisms of injury were described in literature.
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Anatomy
• By four years of age, the radial head and neck have assumed their adult shape with a physiological angulation of the neck in the anteroposterior (AP) plane of an average of 12.5° laterally and in the lateral plane of an average of 3.5° anteriorly.
• In the more common type, a radial neck fracture occurs after a fall with the elbow in extension and valgus, resulting in a fracture with valgus angulation.
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Open reduction
• controversial • outcomes • incidence of
complication • causes additional
damage • open reduction
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K-wires
Fixation
Elastic nailing
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Case 2
• 10-year-old boy sustained a Judet type IV fracture of the radial neck.
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• Postoperative radiograph shows anatomic reduction.The patient showed a minimal incision.
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Tecnique of elastic nailing
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Postoperative radiograph
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Case 1
• A 6-year-old boy sustained a Judet type IV fracture of the radial
reduction.The patient showed an excellent clinical result and
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resumed full motion.
Complication
Infection elbow stiffness avascular necrosis premature physeal closure
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E
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Diagnosis
• history • symptom • physical sign • radiograph
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Treatment
controversy
acceptable degrees
15°~45°
the majority opinion
30°
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• begins at four years and it fuses at the age of 14 in females and 17 in males.
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Characteristic
• age 4～14years
• disease rate: 5% of elbow injuries
or 1% of all injuries in chindren
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Mechanism
Elbow in extension :more common type
Elbow in flexed:rare type
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Judet
Classification
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百度文库 • Wilkins
Reduction
❖ Closed reduction ❖ Percutaneous pin reduction ❖ Open recuction
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Closed reduction
30 ° ～60° ＞60°
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Percutaneous pin reduction
• Risk :radial nerve injury
neck. Follow-up radiograph after elastic nailing shows good
reduction.The patient hpapdt课a件n excellent outcome.
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Case 1
• Follow-up radiograph shows fracture union and anatomic
Radial Neck Fractures in Children Treated With Elastic Stable Intramedullary Nailing
Ningbo No. 6 hospital
Caojin
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Anatomy
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Characteristic
Ossification center
• In the rare type, the mechanism is a fall with the elbow flexed, which causes temporary and posterior dislocation of the elbow joint.