Wilkins K E
University of Texas Health Sciences Center, San Antonio.
Orthop Clin North Am. 1990 Apr;21(2):269-89.
Supracondylar fractures of the humerus occur in either an extension or flexion pattern. Both patterns have three types distinguished by the degree of displacement. Extension fractures, type III patterns in which there is complete displacement, usually require operative intervention in the form of a closed reduction with percutaneous pin fixation. In those in which an adequate reduction is not achieved, an open reduction is the preferred alternative treatment. Recognition of the role of the anterior periosteum in interfering with an adequate reduction is important. In addition, determination of the posteromedial or posterolateral displacement of the distal fragment is important in recognizing which neurovascular structures are more likely to be injured, which pin to place first, and which surgical approach is proper for an open reduction. Flexion fractures, type II displaced fractures, often require pin fixation, and type III displaced fractures usually require an open reduction.
肱骨髁上骨折可呈伸直型或屈曲型。两种类型均有三种根据移位程度区分的类型。伸直型骨折，即III型完全移位骨折，通常需要采取经皮穿针固定闭合复位的手术干预。对于那些未能实现充分复位的骨折，切开复位是首选的替代治疗方法。认识到前方骨膜在妨碍充分复位中所起的作用很重要。此外，确定远端骨折块的后内侧或后外侧移位对于识别哪些神经血管结构更可能受损、首先置入哪根针以及哪种手术入路适合切开复位很重要。屈曲型骨折，即II型移位骨折，通常需要穿针固定，而III型移位骨折通常需要切开复位。
