Sotgiu F, Melis G C, Tolu S
Ital J Orthop Traumatol. 1976 Aug;2(2):281-90.
The authors describe the satisfactory results obtained in sixteen intercondyloid fractures of the humerus, thirteen of which were treated surgically. The preference for surgical treatment in such fractures is based in the assumption that, as in all articular fractures, a good functional result can only be achieved if there is the most perfect possible reconstruction of the fragments and the joint surface. A classification is therefore suggested which is based not purely on anatomical criteria, but is also related to treatment and prognosis. The slendor nature of the distal end of the humerus and the danger of metal reaction call for the use of fixation devices that are efficient but slender, such as fine screws and crossed wires. The precise method of fixation is conditioned above all by the direction of the fracture lines. More solid fixation with early mobilisation can be achieved by compression screws, and less solid fixation with longer immobilisation is achieved by fixation with crossed Kirschner wires. Consequently, the more oblique types of fracture with fragments with long beaks that allow more stable fixation with compression screws have the more favourable prognosis. In the evaluation of results, the authors emphasize the importance of using parameters which take into account the functionally useful range of joint movement.
作者描述了在16例肱骨髁间骨折中取得的满意结果，其中13例接受了手术治疗。对此类骨折倾向于手术治疗的依据是，与所有关节骨折一样，只有在尽可能完美地重建骨折碎片和关节面的情况下，才能获得良好的功能结果。因此建议采用一种分类方法，该方法不仅基于解剖学标准，还与治疗和预后相关。肱骨远端的纤细特性以及金属反应的风险要求使用高效但纤细的固定装置，如细螺钉和交叉钢丝。固定的精确方法首先取决于骨折线的方向。使用加压螺钉可实现更牢固的固定并早期活动，而使用交叉克氏针固定则固定较不牢固且固定时间更长。因此，骨折线越倾斜且碎片有长喙从而允许用加压螺钉进行更稳定固定的类型，预后越良好。在结果评估中，作者强调使用考虑关节运动功能有效范围的参数的重要性。
