Price C T, Scott D S, Kurzner M E, Flynn J C
Matthews Orthopaedic Clinic, Orlando, FL 32856.
J Pediatr Orthop. 1990 Nov-Dec;10(6):705-12. doi: 10.1097/01241398-199011000-00001.
From 1971 to 1986, 80 skeletally immature patients with severe diaphyseal both-bone forearm fractures were treated at Orlando Regional Medical Center. Greenstick, Monteggia, and Galeazzi fractures were excluded. Seventy-nine fractures were managed by closed means. When anatomic reduction could not be obtained, the best position was accepted. There were 47 patients with malunions of whom 39 returned for follow-up evaluation greater than 2 years after injury. They form the basis of this study. There were no delayed unions or nonunions in the entire group. Average follow-up in the group reported was 5 years 9 months (range 2 years to 13 years 10 months). All patients were satisfied with their functional and cosmetic results regardless of age, angulation, complete displacement, or loss of radial bow at time of union. Only nine patients had loss of motion. By our criteria, 36 patients (92%) had good or excellent results, with 32 excellent and four good results. Three patients (8%) had fair results, and there were no poor results. Age at time of injury did not correlate with recovery of motion. Distal fractures were found to have a better prognosis than proximal fractures. Based on the results of this study, closed reduction is the treatment of choice for skeletally immature patients with diaphyseal fractures of the radius and ulna.
1971年至1986年期间，奥兰多地区医疗中心收治了80例骨骼未成熟的严重尺桡骨干双骨折患者。青枝骨折、孟氏骨折和盖氏骨折被排除在外。79例骨折采用闭合方法治疗。当无法获得解剖复位时，接受最佳位置。有47例患者发生畸形愈合，其中39例在受伤后2年以上返回进行随访评估。他们构成了本研究的基础。整个组中没有延迟愈合或不愈合的情况。报告组的平均随访时间为5年9个月（范围为2年至13年10个月）。所有患者对其功能和外观结果均感到满意，无论年龄、成角、完全移位或愈合时桡骨弓的丢失情况如何。只有9例患者有活动度丧失。根据我们的标准，36例患者（92%）结果良好或优秀，其中32例优秀，4例良好。3例患者（8%）结果一般，没有结果差的情况。受伤时的年龄与活动度恢复无关。发现远端骨折的预后比近端骨折更好。基于本研究结果，闭合复位是骨骼未成熟的尺桡骨干骨折患者的首选治疗方法。
