Orthopaedic Registrar, Severn Deanery, Bristol, UK.
Consultant Paediatric Orthopaedic Surgeon, St George's Hospital, London, UK.
Eur J Orthop Surg Traumatol. 2021 Jul;31(5):871-881. doi: 10.1007/s00590-021-02932-2. Epub 2021 Mar 20.
Supracondylar fractures are common injuries accounting for approximately 15% of all fractures in children with a large body of literature on this subject.
This article critically appraises the available evidence to provide an overview of the treatment options including the role and timing of surgery, the geometry of wire fixation and the management of nerve and arterial injury.
Management decisions are based on a number of considerations particularly fracture stability. Closed reduction and percutaneous K-wire stabilisation are commonly recommended for an unstable displaced fracture. These techniques are however associated with the potential for iatrogenic neurological injury. Vascular injury is also rare but must be recognised and treated promptly to avoid significant permanent morbidity.
髁上骨折是儿童中常见的骨折,约占所有骨折的 15%,对此已有大量文献报道。
本文批判性地评估了现有证据,提供了治疗选择的概述,包括手术的作用和时机、钢丝固定的几何形状以及神经和动脉损伤的处理。
管理决策基于许多考虑因素,特别是骨折的稳定性。对于不稳定的移位骨折,通常建议采用闭合复位和经皮 K 线固定。然而,这些技术可能会导致医源性神经损伤。血管损伤也很少见,但必须及时识别和治疗,以避免严重的永久性残疾。