Harwant S, Borhan T A
University Putra Malaysia.
Med J Malaysia. 2000 Sep;55(3):311-7.
156 consecutive children with supracondylar fracture humerus were reviewed. Of these, 56 children with severely displaced fractures were treated with side arm traction. A retrospective review revealed that a mean post-reduction Baumann angle of 74.2 degrees for boys and 75.9 degrees for girls; and mean post-reduction humero-ulna angle of 11.6 degrees for boys and 12.7 degrees for girls was achieved. A linear correlation was noted between the duration of traction and the age of the patient, older patients requiring longer traction. The region below the line in the graph, plotting the duration of traction (y-axis) versus the age of the patient (x-axis) shows when the fracture is unstable; and the region above the line shows when the fracture is stable and can only be reduced by surgery. 10 children presented late; 6 presented within the unstable period and were successfully reduced with traction; while 4 presented stable and required open reduction. We conclude that traction is an acceptable and safe method for reduction of this fracture, and can be used to reduce late presentations while their fractures are still unstable.
对156例肱骨髁上骨折患儿进行了回顾性研究。其中，56例严重移位骨折患儿采用侧臂牵引治疗。回顾性研究显示，复位后男孩的平均鲍曼角为74.2度，女孩为75.9度；男孩复位后的平均肱尺角为11.6度，女孩为12.7度。牵引时间与患者年龄之间存在线性相关性，年龄较大的患者需要更长时间的牵引。在以牵引时间（y轴）与患者年龄（x轴）作图的图表中，线以下的区域表示骨折不稳定的情况；线以上的区域表示骨折稳定且只能通过手术复位的情况。10例患儿就诊较晚；6例在不稳定期内就诊，通过牵引成功复位；而4例就诊时骨折稳定，需要切开复位。我们得出结论，牵引是一种可接受且安全的骨折复位方法，可用于复位就诊较晚且骨折仍不稳定的患儿。
