一例6岁患儿肘关节前骨折脱位合并尺神经麻痹
- 作者: Ashar N.1,2,3, Liew S.1, Azmi N.2, Yeak R.1, Lingam R.2, Chen R.2
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隶属关系:
- Universiti Putra Malaysia
- Hospital Serdang
- Universiti Teknologi MARA (UiTM), Jalan Hospital
- 期: 卷 8, 编号 2 (2020)
- 页面: 207-212
- 栏目: Clinical cases
- URL: https://journal-vniispk.ru/turner/article/view/17721
- DOI: https://doi.org/10.17816/PTORS17721
- ID: 17721
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详细
背景:肘关节前骨折脱位在儿童患者中尤为罕见。在目前报道的病例中,四分之三为肘关节后脱位。肘关节前脱位的报道较少,其发生率仅不到2%。
临床病例。1例6岁女孩在厕所摔倒后左肘部发生畸形且疼痛,遂前往急诊室就诊。尺骨鹰爪表现为尺神经分布感觉减退。未见伤口,远端搏动及循环良好。X线显示左肘前脱位合并鹰嘴骨折。曾尝试闭合手法复位,但未成功。在全身麻醉下进行切开复位并经皮插入克氏针。由肘关节内侧入路。术中发现尺神经被远端尺骨碎片撞击,但仍保持连续。横向鹰嘴骨折用两根克氏针固定,复位桡骨头。尺神经可活动直至无张力。修复尺侧副韧带。肘部用夹板固定。尺骨鹰爪于第2周恢复。骨折于第6周愈合,去除克氏针。第8周,肘部可完全活动。肘部内外翻稳定。
讨论。肘关节前脱位是高能量损伤,应留意神经血管损伤。文献未对手术入路作出明确建议。我们选择肘部内侧入路进行尺神经探查和鹰嘴固定。
结论。该罕见损伤应以高度可疑指标处理。手术入路应根据肘关节的不稳定和神经血管状况单独设计,如本例为尺神经麻痹引起的后内侧不稳定。
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作者简介
Nur Ayuni Khirul Ashar
Universiti Putra Malaysia; Hospital Serdang; Universiti Teknologi MARA (UiTM), Jalan Hospital
Email: ayuni.kashar@gmail.com
ORCID iD: 0000-0003-3556-0721
D-r, MBBS (UiTM), Postgraduate student & Medical Officer of the Department of Orthopaedic, Faculty of Medicine and Health Sciences
马来西亚, Serdang, Selangor; Jalan Puchong, Kajang, Selangor; Sungai Buloh, SelangorSiew Khei Liew
Universiti Putra Malaysia
编辑信件的主要联系方式.
Email: kheils@upm.edu.my
ORCID iD: 0000-0003-4419-1382
D-r, MBBS (UM), MS ORTH (UM), Orthopaedic Surgeon, Hand and Reconstructive Microsurgery Unit of the Department of Orthopaedic, Faculty of Medicine and Health Sciences
马来西亚, Serdang, SelangorNur Syahirah Azmi
Hospital Serdang
Email: syahirahazmi90@gmail.com
ORCID iD: 0000-0002-4057-3749
D-r, MB BCh (Mansoura University), Medical Officer of the Department of Orthopaedic
马来西亚, Jalan Puchong, Kajang, SelangorRaymond Dieu Kiat Yeak
Universiti Putra Malaysia
Email: rayyeak@yahoo.com
ORCID iD: 0000-0001-8232-5359
D-r, MB BCh BAO (PMC), MS ORTH (UM), Orthopaedic Surgeon, Sports Surgery Unit of the Department of Orthopaedic, Faculty of Medicine and Health Sciences
马来西亚, Serdang, SelangorRahul Lingam
Hospital Serdang
Email: silverseraph15@yahoo.com
ORCID iD: 0000-0002-0546-3077
D-r, MD (KSMU), Doctor of Medicine, Medical Officer of the Department of Orthopaedic
马来西亚, Jalan Puchong, Kajang, SelangorRaimi Adam Chen
Hospital Serdang
Email: hadoken86@gmail.com
Scopus 作者 ID: 0000-0003-0362-521X
D-r, MD (RSMU), Doctor of Medicine, Medical Officer of the Department of Orthopaedic
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