摘要为了积极有效地治疗儿童肘部损伤后发生的肘外翻畸形,对肘外翻发生的原因、预防和治疗进行讨论.本组共26例,肘部损伤时年龄2～14岁(平均7.5岁).儿童肘部损伤为肱骨外髁骨折14例,肱骨外髁骨折合并桡骨小头脱位1例,肱骨髁上骨折8例,肱骨内髁骨折1例,桡骨小头脱位2例.肘关节提携角20～45°(平均28°).合并创伤性尺神经炎19例.创伤性关节炎7例.19例合并创伤性尺神经炎作神经松解前移术,平均随访6.6年,优良率88.2%.5例肘外翻作肱骨髁上截骨术,平均随访9.4年,肘关节外观及功能满意.结论:延误诊治、复位固定不良是儿童肘部损伤后发生肘外翻的原因.早期诊断、及时准确复位和确切固定是减少肘外翻发生的重要措施.对有移位的骨折的反复手法复位可加重骨骺损伤.8岁以上严重肘外翻畸形可作肱骨髁上截骨术矫正,合并创伤性尺神经炎应早期作尺神经松解前移术.

abstractsTwenty-six cases with cubitus deformity following elbow trauma are reported.The age ranged from 2～14 years(mean 7.5 yrs).The elbow traumas included:fractures of the lateral condyle of the humerus(14),fracture of lateral condyle associated with dislocation of the radial head(1),supracondylar fractures(8),fractures of medial condyle(2),and dislocations of radial head(2).The late complications included:traumatic ulnar neuritis(19)and traumatic arthritis (7).Neurolysis and anterior transposition of ulnar nerve were performed on 19 cases with traumatic ulnar neuritis.The follow-up study(mean 6.6 years)showed excellent and good results in 88.2%.Supracondylar osteotomy of the humerus for correction of cubitus valgus were done on 5 cases and were follow-up for 9.4 years in average.A satisfactory function and good appearance of the elbow was obtained.Repeated manipulation of the displaced fracture may cause impairment of the epiphysis.A supracondylar humeral osteotomy should be performed on patients over 8 years of age with obvious deformity.The complicated ulnar neuritis should be treated by early neurolysis and anterior transposition.