Pirone A M, Graham H K, Krajbich J I
Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
J Bone Joint Surg Am. 1988 Jun;70(5):641-50.
The cases of 230 patients who had a displaced extension-type supracondylar fracture of the humerus were reviewed retrospectively. The results of treatment by four different methods were assessed clinically and compared. The mean length of follow-up was 4.6 years (range, one to nine years). The highest percentages of excellent results were achieved by percutaneous Kirschner-wire fixation (78 per cent), skeletal traction (67 per cent), and open reduction with internal fixation (67 per cent). Closed reduction and application of a cast was associated with a significantly lower percentage of early and late complications, including Volkmann ischemic contracture and cubitus varus. It is recommended that treatment with a cast be reserved for undisplaced fractures only. Percutaneous Kirschner-wire fixation is advocated as the method of choice for the majority of displaced fractures.
对230例肱骨髁上伸直型移位骨折患者的病例进行了回顾性研究。对四种不同治疗方法的结果进行了临床评估和比较。平均随访时间为4.6年（范围为1至9年）。经皮克氏针固定（78%）、骨牵引（67%）和切开复位内固定（67%）取得的优良结果比例最高。闭合复位加石膏固定的早期和晚期并发症（包括Volkmann缺血性挛缩和肘内翻）发生率显著较低。建议石膏固定仅用于无移位骨折。对于大多数移位骨折，提倡采用经皮克氏针固定作为首选方法。
