Guven Mehmet F, Kaynak Gokhan, Inan Muharrem, Caliskan Gurkan, Unlu Hiclal B, Kesmezacar Hayrettin
Department of Orthopaedics and Traumatology, Istanbul University, Cerrahpasa Faculty of Medicine, Kocamustafapasa, Istanbul, Turkey.
Department of Orthopaedics and Traumatology, Istanbul University, Cerrahpasa Faculty of Medicine, Kocamustafapasa, Istanbul, Turkey.
J Shoulder Elbow Surg. 2015 Apr;24(4):640-6. doi: 10.1016/j.jse.2014.12.010. Epub 2015 Jan 31.
The aim of this study was to evaluate the long-term functional and cosmetic results as well as the sagittal and coronal plane remodeling of displaced supracondylar humerus fractures treated with open reduction and internal fixation.
In total, 49 patients (11 boys and 38 girls) with Gartland type III supracondylar humerus fractures treated with open reduction and cross-pin fixation were retrospectively evaluated. The mean follow-up time was 22.4 years (range, 10.6-37.5 years). The Flynn criteria were used to assess the cosmetic and functional outcomes. Baumann's angle, the lateral rotational percentage, the humerus-elbow-wrist angle, and the humeral condylar angle were obtained from follow-up radiographs. The flexion and extension deficits compared with the uninjured side were measured at the last follow-up.
According to the Flynn criteria, the cosmetic outcomes were satisfactory in 93.9% of the patients, and the functional outcomes were satisfactory in 83.7% of the patients. The average flexion deficit was 5° ± 8°, and the average extension deficit was 4° ± 5°. At the final follow-up, the mean difference in the humerus-elbow-wrist angle and the humeral condylar angle between the injured and uninjured sides was -4° ± 7° and 0° ± 3°.
We identified the remodeling in the sagittal plane in supracondylar humerus fractures that had been united in flexion. Satisfactory functional and cosmetic results were obtained with the open reduction and internal fixation of displaced supracondylar fractures of the humerus, and no degenerative changes were observed at the long-term follow-up.
本研究的目的是评估切开复位内固定治疗移位性肱骨髁上骨折的长期功能和美容效果以及矢状面和冠状面的重塑情况。
回顾性评估49例采用切开复位交叉克氏针固定治疗的Gartland III型肱骨髁上骨折患者（11例男孩和38例女孩）。平均随访时间为22.4年（范围10.6 - 37.5年）。采用Flynn标准评估美容和功能结果。从随访X线片获取鲍曼角、外侧旋转百分比、肱-肘-腕角和肱骨髁角。在最后一次随访时测量与未受伤侧相比的屈伸功能障碍。
根据Flynn标准，93.9%的患者美容效果满意，83.7%的患者功能效果满意。平均屈曲功能障碍为5°±8°，平均伸展功能障碍为4°±5°。在最后一次随访时，受伤侧与未受伤侧的肱-肘-腕角和肱骨髁角的平均差异分别为-4°±7°和0°±3°。
我们发现屈曲愈合的肱骨髁上骨折在矢状面有重塑。肱骨移位性髁上骨折切开复位内固定获得了满意的功能和美容效果，长期随访未观察到退行性改变。
