Abstract：
OBJECTIVE: This work aimed to evaluate the results of using a 2-stage surgical treatment strategy without doing anterior transposition of the ulnar nerve (ATUN) for cases with long-standing nonunited fracture lateral humeral condyle (LHC) in children, accompanied by a critical review.
METHODS: A consecutive 12 children with a long-standing \">2 years\" nonunited LHC with evident radiologic gross anatomic distortion of the elbow were included in this study. A 2-stage surgical treatment strategy was applied, wherein the first stage, open functional reduction, osteosynthesis, and iliac bone graft were done. Then after 6 months, the second stage surgery was carried out in the form of supracondylar humeral corrective osteotomy if the cubitus valgus angle was ≥20 degrees. ATUN was not done for any of the cases even with those having ulnar nerve dysfunction.
RESULTS: Union took place in 11 out of the 12 cases after a mean follow-up period of 11 weeks (range: 8 to 14 wk; SD: 1.6). All the 7 cases showed preoperative ulnar nerve dysfunction and reported clinical recovery at the end of their follow-up.
CONCLUSIONS: Two-stage surgical treatment strategy without ATUN is a convenient, reproducible, and successful line of treatment for children presented with longstanding nonunited LHC with anatomically distorted elbow.
METHODS: Level IV-case series.
METHODS: A consecutive 12 children with a long-standing \">2 years\" nonunited LHC with evident radiologic gross anatomic distortion of the elbow were included in this study. A 2-stage surgical treatment strategy was applied, wherein the first stage, open functional reduction, osteosynthesis, and iliac bone graft were done. Then after 6 months, the second stage surgery was carried out in the form of supracondylar humeral corrective osteotomy if the cubitus valgus angle was ≥20 degrees. ATUN was not done for any of the cases even with those having ulnar nerve dysfunction.
RESULTS: Union took place in 11 out of the 12 cases after a mean follow-up period of 11 weeks (range: 8 to 14 wk; SD: 1.6). All the 7 cases showed preoperative ulnar nerve dysfunction and reported clinical recovery at the end of their follow-up.
CONCLUSIONS: Two-stage surgical treatment strategy without ATUN is a convenient, reproducible, and successful line of treatment for children presented with longstanding nonunited LHC with anatomically distorted elbow.
METHODS: Level IV-case series.
摘要：
目的：这项工作旨在评估在不进行尺神经前移位（ATUN）的情况下使用2阶段手术治疗策略治疗儿童肱骨外髁（LHC）长期不联合骨折患者的结果。伴随着一个关键的审查。
方法：这项研究包括了连续12名长期“>2年”非联合大型强子对撞机并伴有明显的放射学大体肘部解剖变形的儿童。采用2期手术治疗策略，其中第一阶段，开放功能减少，骨合成,和髂骨移植。6个月后,如果肘外翻角≥20度，则以肱骨髁上矫正截骨术的形式进行第二阶段手术。即使有尺神经功能障碍的患者也没有对任何病例进行ATUN。
结果：在平均11周的随访期（范围：8至14周；SD：1.6）后，12例中有11例发生了Union。7例术前均表现为尺神经功能障碍，随访结束时报告临床恢复。
结论：无ATUN的两阶段手术治疗策略是一种方便的，可重复,并成功治疗了长期未联合的LHC和解剖学扭曲的肘部。
方法：IV级病例系列。
方法：这项研究包括了连续12名长期“>2年”非联合大型强子对撞机并伴有明显的放射学大体肘部解剖变形的儿童。采用2期手术治疗策略，其中第一阶段，开放功能减少，骨合成,和髂骨移植。6个月后,如果肘外翻角≥20度，则以肱骨髁上矫正截骨术的形式进行第二阶段手术。即使有尺神经功能障碍的患者也没有对任何病例进行ATUN。
结果：在平均11周的随访期（范围：8至14周；SD：1.6）后，12例中有11例发生了Union。7例术前均表现为尺神经功能障碍，随访结束时报告临床恢复。
结论：无ATUN的两阶段手术治疗策略是一种方便的，可重复,并成功治疗了长期未联合的LHC和解剖学扭曲的肘部。
方法：IV级病例系列。
