Zorrilla S de Neira Jaime, Prada-Cañizares Alfonso, Marti-Ciruelos Rafael, Pretell-Mazzini Juan
Department of Orthopaedic Surgery, 12 de Octubre University Hospital, Madrid, Spain.
Pediatric Orthopaedic Division/Department of Orthopaedics, 12 de Octubre University Hospital, Madrid, Spain.
Int Orthop. 2015 Nov;39(11):2287-96. doi: 10.1007/s00264-015-2975-4. Epub 2015 Aug 28.
Supracondylar humeral fractures are the most common elbow fractures in children and represent 3 % of all paediatric fractures. The most common cause is a fall onto an outstretched hand with the elbow in extension, resulting in an extension-type fracture (97-99 % of cases). Currently, the Gartland classification is used, which has treatment implications. Diagnosis is based on plain radiographs, but accurate imaging could be limited due to patient pain. Based on fracture type, the definitive treatment could be either non-operative (type I) or operative (type III/IV); however, when handling type II fractures controversy remains. Neither pin configuration have shown higher efficacy over the other. Complications are ~1 %, the most common being pin migration, with compartment syndrome as the most devastating. Overall, functional outcomes are good, and physical therapy does not appear to be necessary.
肱骨髁上骨折是儿童最常见的肘部骨折，占所有儿科骨折的3%。最常见的原因是伸直手臂摔倒，肘部处于伸展状态，导致伸展型骨折（占病例的97-99%）。目前，采用的是加特兰分类法，该分类法对治疗有指导意义。诊断基于X线平片，但由于患者疼痛，准确的影像学检查可能会受到限制。根据骨折类型，确定性治疗可以是非手术治疗（I型）或手术治疗（III/IV型）；然而，在处理II型骨折时仍存在争议。两种钢针配置均未显示出比另一种更高的疗效。并发症发生率约为1%，最常见的是钢针移位，骨筋膜室综合征是最严重的并发症。总体而言，功能预后良好，似乎不需要物理治疗。
