Schneidmueller D, Boettger M, Laurer H, Gutsfeld P, Bühren V
Abteilung Unfallchirurgie, Sportorthopädie und Kindertraumatologie, Klinikum Garmisch-Partenkirchen, BG-Unfallklinik Murnau, Prof.- Küntscher-Straße 8, 82418, Murnau, Deutschland,
Orthopade. 2013 Nov;42(11):977-85; quiz 986-7. doi: 10.1007/s00132-013-2203-0.
Fractures of the distal humerus belong to the most common injuries of the upper arm in childhood. Most frequently occurring is the supracondylar fracture of the distal humerus. In these cases and in the second most common epicondylar fractures, the metaphysis is affected and these fractures are therefore extra-articular. They have to be distinguished from articular fractures regarding therapy and prognosis. The growth potential of the distal epiphysis is very limited as is the possibility of spontaneous correction so that major dislocations should not be left uncorrected. Unstable and especially dislocated articular fractures must be anatomically reconstructed employing various osteosynthetic techniques, mostly combined with immobilization. Insufficient reconstruction, growth disturbance and non-union can result in axial deformities, such as cubitus valgus and varus, restriction of motion, pain and nerve palsy.
肱骨远端骨折是儿童上臂最常见的损伤之一。最常见的是肱骨远端髁上骨折。在这些病例以及第二常见的髁上骨折中，干骺端受到影响，因此这些骨折为关节外骨折。在治疗和预后方面，它们必须与关节内骨折相区分。远端骨骺的生长潜力非常有限，自发矫正的可能性也很小，因此严重脱位不应不进行矫正。不稳定尤其是脱位的关节内骨折必须采用各种骨合成技术进行解剖重建，大多需结合固定。重建不足、生长紊乱和骨不连可导致轴向畸形，如肘外翻和肘内翻、活动受限、疼痛和神经麻痹。
