Diagnosis and treatment of "medial to lateral diagonal injury of the elbow" in children: Concomitant medial epicondylar and radial neck fractures.

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-08-01 DOI:10.1177/18632521231182422
Yunan Lu, Federico Canavese, Yongjie Xia, Ran Lin, Dianhua Huang, Tianlai Chen, Shunyou Chen
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引用次数: 1

Abstract

Purpose: The simultaneous and ipsilateral occurrence of medial epicondylar and radial neck fractures is rare. This study evaluated the clinical and radiological outcomes of medial to lateral diagonal injury of the elbow (MELAINE).

Methods: Six males and 6 females were diagnosed with MELAINE (left: 10, 83.3%; right: 2, 16.7%). Medial epicondylar and radial neck fractures were classified according to Papavasiliou's classification (seven type II, two type III, three type IV) and Judet's classification (three type I, four type II and five type III), respectively. All patients underwent surgery. The carrying angle, range of motion, and Kim et al. Elbow Performance Score were used to evaluate clinical and functional outcomes; related complications were recorded.

Results: Mean age at injury and mean follow-up were 11.1 ± 2.5 (range, 6-14) and 40 ± 25.6 months (range, 13-90), respectively. All fractures consolidated in 6.3 ± 1.2 weeks on average (4-9). Outcomes were good (n = 1; 8.3%) to excellent (n = 11; 91.7%). The carrying angle of the injured and uninjured side was 15.5°± 2.6° and 14.7°± 2°, respectively (p = 0.218). The range of motion of elbow flexion-extension and forearm pronation-supination of the injured side was 144.2°± 10.4°, 4.6°± 5.4°, 76.7°± 9.1°, 80.4°± 9.2°, respectively, with no significant differences from the healthy side (p > 0.05). The Elbow Performance Score of the injured and uninjured side was 96.3 ± 5.3 and 98.8 ± 2.3, respectively (p = 0.139). No cases of infection, cubitus valgus, stiffness, or instability were recorded.

Conclusion: Although uncommon, MELAINE should not be neglected. Surgery aims to stabilize the elbow and avoid valgus deformity. If diagnosed and treated, clinical and radiological results are excellent in most cases.

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儿童“肘关节内外侧对角线损伤”的诊断和治疗:并发内上髁和桡骨颈骨折。
目的:肱骨内上髁及桡骨颈骨折同时及同侧发生实属罕见。本研究评估肘关节内外侧对角线损伤(MELAINE)的临床和影像学结果。方法:男性6例,女性6例(左:10例,占83.3%;右:2,16.7%)。内上髁和桡骨颈骨折分别按Papavasiliou分型(II型7例,III型2例,IV型3例)和Judet分型(I型3例,II型4例,III型5例)进行分类。所有患者均接受手术治疗。搬运角度,运动范围,以及Kim等。肘部功能评分用于评估临床和功能结果;记录相关并发症。结果:患者平均受伤年龄11.1±2.5个月(范围6 ~ 14),平均随访时间40±25.6个月(范围13 ~ 90)。所有骨折平均在6.3±1.2周内愈合(4-9)。结果良好(n = 1;8.3%)至优秀(n = 11;91.7%)。损伤侧和未损伤侧的携带角分别为15.5°±2.6°和14.7°±2°(p = 0.218)。损伤侧肘关节屈伸和前臂旋前活动范围分别为144.2°±10.4°、4.6°±5.4°、76.7°±9.1°、80.4°±9.2°,与健康侧比较差异无统计学意义(p > 0.05)。损伤侧与未损伤侧肘关节功能评分分别为96.3±5.3和98.8±2.3,差异有统计学意义(p = 0.139)。没有感染、肘外翻、僵硬或不稳定的病例记录。结论:美黑碱虽罕见,但不可忽视。手术的目的是稳定肘关节,避免外翻畸形。如果得到诊断和治疗,大多数病例的临床和放射学结果都很好。
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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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