术中肘关节造影辅助治疗低龄儿童桡骨颈骨折

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Abstract Objective To observe the effect of intraoperative elbow arthrography in reduction of radial neck fractures of the young children and solve the problem caused by the nonvisulization of radial head ossified nucleus.Methods Intraoperative elbow arthrographies were performed in 16 cases of radial neck fractures whose radial head nuclei were not clear in X ray image and then the reductions were performed by leverage of percutaneous Kirschner wire.There were 7 males and 9 females.The average age was 5 years and 1 month old. According to O’brien classification，there were 9 cases of type Ⅱ and 7 cases of type Ⅲ.The approach of lateral of the elbow joint was chosen to perform the arthrography.Iohexol was the contrast agent.After satisfactory reduction，two Kirschner needles were fixed through the fracture site or the proximal fracture site.The occurrence of postoperative complications and the clinical effects were observed.Results Intraoperative elbow arthrography could clearly show the articular surface of the radial head，assistpercutaneous leveragereduction.According to the reduction criterion of Metaizeau，14 cases were excellent，2 cases were good，and the excellent and good rate was 100%.From follow up of average 21months(range 9 months to 30 months)，16 cases were excellent according to the effect criterion of Metaizeau，and the excellent and good rate was 100%.There was no proximal osseous junction and no ischemic necrosis of the radial head.No needle infection or injury to the deep branch of the radial nerve occurred.There was no postoperative complications.Conclusion Closed reduction assisted by intraoperative elbow arthrography through percutaneous reduction by leverage and internal fixation can effectively improve the excellent and good rate of reduction of radial neck fracture in children without visulization of radial head ossified nucleus in young children.

Key words： elbow joint arthrography children radial neck fracture

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