Goudarzi Y M
Unfallchirurgie. 1987 Feb;13(1):8-13. doi: 10.1007/BF02585824.
In the time from 1972 through 1985 173 children with supracondylar fractures of the humerus were treated according to the fracture type with two upper arm plaster splints, nail extension from von Ekesparre and in special cases with open reduction and fixation with Kirschner wires-osteosynthese. As primary complications due to accidents we discovered 4% lesions of the arm nerves and in 1.5% disturbance of the blood circulation, of which 0.5% were due to vessel lesions. All nerve lesions could be treated conservatively, however, one child had to be operated because of ischemia of the lower arm and hand. Through reconstruction of the Arteria brachialis the disturbance of the blood circulation could be remedied. Two children with varus- und torsions deformity had to undergo a correcting osteotomy. From the methods used by us for the treating of dislocated fracture of supracondylar humerus in childhood, the nail extension from von Ekesparre found priority. An open reduction was then indicated when the fracture could neither through the conservative treatment nor the nail extension be held in a good reduction position. Further indications for surgery were if circulation remains disturbed or if paralysis persists.
在1972年至1985年期间，173例肱骨髁上骨折患儿根据骨折类型接受了治疗，采用了两种上臂石膏夹板、冯·埃克斯帕尔（von Ekesparre）钉牵引，特殊情况下采用切开复位并用克氏针-骨合成固定。作为事故导致的主要并发症，我们发现4%的患儿出现臂神经损伤，1.5%的患儿出现血液循环障碍，其中0.5%是由于血管损伤。所有神经损伤均采用保守治疗，然而，有一名患儿因前臂和手部缺血而不得不接受手术。通过重建肱动脉，血液循环障碍得以纠正。两名出现内翻和扭转畸形的患儿不得不接受矫正截骨术。在我们用于治疗儿童肱骨髁上骨折脱位的方法中，冯·埃克斯帕尔钉牵引最为常用。当骨折既不能通过保守治疗也不能通过钉牵引维持在良好的复位位置时，则需进行切开复位。手术的其他指征包括血液循环持续障碍或麻痹持续存在。
