From The Royal Children's Hospital Melbourne, Parkville, VIC, Australia (Annabell), and the Boston Children's Hospital, Boston, MA (Shore, Hedequist, and Hogue).
J Am Acad Orthop Surg. 2023 Mar 15;31(6):265-273. doi: 10.5435/JAAOS-D-22-00443. Epub 2022 Dec 12.
Diaphyseal humerus fractures in the pediatric population have dynamic treatment strategies that depend on injury pattern, mechanism, patient skeletal maturity, and size. Treatment strategies include closed reduction with various immobilization techniques, flexible nails, uniplanar or multiplanar external fixation, or plate osteosynthesis. Accepted parameters for sagittal and coronal alignment vary based on age and potential for remodeling, and the multiplanar motion of the shoulder joint can accommodate for greater variations in alignment than many other long bone fractures. Complications such as radial nerve palsy are possible with both open and closed injuries, and mal/nonunions, although rare, can occur. Overall, treatment should be predicated on a full evaluation of the patient, fracture, local soft tissues, and any concomitant injuries.
儿童肱骨干骨折的治疗策略具有动态性，取决于损伤类型、机制、患者骨骼成熟度和体型。治疗策略包括闭合复位联合各种固定技术、弹性钉、单平面或多平面外固定架或钢板内固定。基于年龄和重塑潜力，矢状面和冠状面的可接受对线参数有所不同，肩关节的多平面运动可以适应比许多其他长骨骨折更大的对线变化。无论是开放性还是闭合性损伤都可能导致桡神经麻痹等并发症，虽然很少见，但也可能发生畸形/不愈合。总的来说，治疗应基于对患者、骨折、局部软组织和任何伴随损伤的全面评估。
