儿童桡骨颈骨折治疗 ppt课件.pptVIP

Fixation K-wires 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. Case 1 Follow-up radiograph shows fracture union and anatomic reduction.The patient showed an excellent clinical result and resumed full motion. Complication 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. 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. 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. 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. 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. Acceptable degrees of angulation range from 15 to 45 degrees. We agree with the majority who recommend treating fractures with an angulation of less than 30 degrees with immobilization alone and those with more than 30 degrees angulation by means of surgery. Reduction’ The severely angulated fractures can be treated with closed reduction, p