Otsuka NY, Kasser JR
Surgery, University of California, San Francisco (UCSF), and Pediatric Orthopaedic Service, UCSF Medical Center.
J Am Acad Orthop Surg. 1997 Jan;5(1):19-26. doi: 10.5435/00124635-199701000-00003.
The treatment of type II and type III supracondylar fractures of the humerus in children with closed reduction and percutaneous pinning has dramatically lowered the rate of complications from this injury. The incidence rates of malunion (cubitus varus) and compartment syndrome have both decreased. Nerve injury accompanying this type of fracture (prevalence, 5% to 19%) is usually a neurapraxia, which should be managed conservatively. Vascular insufficiency at presentation (prevalence, 5% to 17%) should be managed initially by rapid closed reduction and pinning without arteriography. Persistent vascular insufficiency necessitates exploration and vascular reconstruction.
采用闭合复位和经皮穿针治疗儿童肱骨髁上Ⅱ型和Ⅲ型骨折,显著降低了该损伤的并发症发生率。骨折畸形愈合(肘内翻)和骨筋膜室综合征的发生率均有所下降。此类骨折伴发的神经损伤(发生率为5%至19%)通常为神经失用,应采取保守治疗。伤后出现血管功能不全(发生率为5%至17%)时,应首先进行快速闭合复位和穿针,无需行动脉造影。持续性血管功能不全则需要进行探查和血管重建。