Devnani A S
Department of Orthopaedics, School of Medical Sciences and University Hospital, Universiti Sains Malaysia, 15990 Kubang Kerian, Kota Baru, Kelantan, Malaysia.
Singapore Med J. 2000 Sep;41(9):436-40.
To study the outcome of gradual reduction by skin traction of supracondylar fracture of the humerus in children with swollen elbow, who seek treatment two days or longer after the injury.
Fifteen children aged between 4 and 11 years (average 7 years 11 months), who had initially consulted a traditional practitioner, reported between 2 and 21 days (average 7.5) after the injury were treated by skin traction with the elbow kept straight and the forearm in position of comfort.
The average duration of stay in hospital was 14 days. All fractures healed; there was no incidence of myositis ossificans or neurovascular deficit. All patients had functional range of movements at the elbow within 6 months. Five patients developed cubitus varus deformity greater than 5 degrees, they were classified as poor result. Four out of these 5 patients had sought treatment after a delay of 7 days or longer. There were 9 good (60%), 1 fair (7%) and 5 poor (33%) results.
Gradual reduction by skin traction is safe. It is possible to achieve satisfactory reduction if the delay is up to 7 days. The results with regards to deformity and function were comparable with those obtained following open or closed Kirschner wire fixation.
研究对伤后2天或更长时间就诊的肘部肿胀的儿童肱骨髁上骨折采用皮肤牵引逐渐复位的效果。
15名年龄在4至11岁（平均7岁11个月）的儿童，最初咨询过传统治疗师，在受伤后2至21天（平均7.5天）就诊，采用皮肤牵引治疗，保持肘部伸直，前臂处于舒适位置。
平均住院时间为14天。所有骨折均愈合；未发生骨化性肌炎或神经血管损伤。所有患者在6个月内肘部活动范围均正常。5例患者出现大于5度的肘内翻畸形，被归类为效果差。这5例患者中有4例在受伤7天或更长时间后才寻求治疗。结果为9例良好（60%），1例一般（7%），5例差（33%）。
皮肤牵引逐渐复位是安全的。如果延迟时间长达7天，有可能实现满意的复位。在畸形和功能方面的结果与开放或闭合克氏针固定后的结果相当。
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