儿童桡骨颈骨折治疗
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• The proximal radial epiphysis is mainly supplied by periosteal blood vessels running from distal to proximal.
Mechanism’
• 2 main mechanisms of injury were described in literature.
damage • open reduction
K-wires
Fixation
Elastic nailing
Tecnique of elastic nailing
Postoperative radiograph
Case 1
• A 6-year-old boy sustained a Judet type IV fracture of the radial neck. Follow-up radiograph after elastic nailing shows good reduction.The patient had an excellent outcome.
fuses at the age of 14 in females and 17 in males.
Characteristic
• age 4～14years
• disease rate: 5% of elbow injuries
or 1% of all injuries in chindren
Mechanism
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.
Treatment
controversy
acceptable degrees
15°~45°
the majority opinion
30°
Reduction
Closed reduction Percutaneous pin reduction Open recuction
Closed reduction
Case 1
• Follow-up radiograph shows fracture union and anatomic reduction.The patient showed an excellent clinical result and resumed full motion.
Complication
30 ° ～60° ＞60°
Percutaneous pin reduction
• Risk :radial nerve injury
Open redLeabharlann Baiduction
• controversial • outcomes • incidence of
complication • causes additional
Radial Neck Fractures in Children Treated With Elastic Stable Intramedullary Nailing
Ningbo No. 6 hospital
Caojin
Anatomy
Characteristic
Ossification center • begins at four years and it
• In the rare type, the mechanism is a fall with the elbow flexed, which causes temporary and posterior dislocation of the elbow joint.
Treatment’
There is still some controversy about management of radial neck fractures in children.
Elbow in extension :more common type
Elbow in flexed:rare type
Judet
Classification
• Wilkins D
E
Diagnosis
• history • symptom • physical sign • radiograph
• 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.
Infection elbow stiffness avascular necrosis premature physeal closure
Advantage of ESIN
minimally invasive technique stable fixation early mobilization anatomical reduction lower complication rate good-to-excellent results
Case 2
• 10-year-old boy sustained a Judet type IV fracture of the radial neck.
• Postoperative radiograph shows anatomic reduction.The patient showed a minimal incision.
Mechanism’
• 2 main mechanisms of injury were described in literature.
damage • open reduction
K-wires
Fixation
Elastic nailing
Tecnique of elastic nailing
Postoperative radiograph
Case 1
• A 6-year-old boy sustained a Judet type IV fracture of the radial neck. Follow-up radiograph after elastic nailing shows good reduction.The patient had an excellent outcome.
fuses at the age of 14 in females and 17 in males.
Characteristic
• age 4～14years
• disease rate: 5% of elbow injuries
or 1% of all injuries in chindren
Mechanism
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.
Treatment
controversy
acceptable degrees
15°~45°
the majority opinion
30°
Reduction
Closed reduction Percutaneous pin reduction Open recuction
Closed reduction
Case 1
• Follow-up radiograph shows fracture union and anatomic reduction.The patient showed an excellent clinical result and resumed full motion.
Complication
30 ° ～60° ＞60°
Percutaneous pin reduction
• Risk :radial nerve injury
Open redLeabharlann Baiduction
• controversial • outcomes • incidence of
complication • causes additional
Radial Neck Fractures in Children Treated With Elastic Stable Intramedullary Nailing
Ningbo No. 6 hospital
Caojin
Anatomy
Characteristic
Ossification center • begins at four years and it
• In the rare type, the mechanism is a fall with the elbow flexed, which causes temporary and posterior dislocation of the elbow joint.
Treatment’
There is still some controversy about management of radial neck fractures in children.
Elbow in extension :more common type
Elbow in flexed:rare type
Judet
Classification
• Wilkins D
E
Diagnosis
• history • symptom • physical sign • radiograph
• 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.
Infection elbow stiffness avascular necrosis premature physeal closure
Advantage of ESIN
minimally invasive technique stable fixation early mobilization anatomical reduction lower complication rate good-to-excellent results
Case 2
• 10-year-old boy sustained a Judet type IV fracture of the radial neck.
• Postoperative radiograph shows anatomic reduction.The patient showed a minimal incision.