Aitken G K, Rorabeck C H
Clin Orthop Relat Res. 1986 Jun(207):191-7.
Distal humeral fractures in the adult often are complicated by pseudarthrosis, pain, and limitation of motion. Of 29 adult patients with distal humeral fractures treated in teaching hospitals, 22 obtained acceptable results. Twenty-two percent of those treated by open methods and 36% of those treated by closed methods had unacceptable results. Ninety percent of the patients starting physiotherapy within six weeks of injury recovered well, while over half of those starting physiotherapy after six weeks had unsatisfactory results. Even comminuted fractures healed when treated by internal fixation and started early on exercises. The most important indicator of end result was the starting time of physiotherapy. Rigid internal fixation is recommended for this fracture, but if stability is not likely to be accomplished by open reduction, nonoperative measures are preferable.
成人肱骨远端骨折常并发假关节形成、疼痛和活动受限。在教学医院接受治疗的29例成人肱骨远端骨折患者中，22例取得了可接受的结果。采用开放方法治疗的患者中有22%以及采用闭合方法治疗的患者中有36%取得了不可接受的结果。90%在受伤后六周内开始物理治疗的患者恢复良好，而在六周后开始物理治疗的患者中有超过一半的结果不理想。即使是粉碎性骨折，通过内固定治疗并尽早开始锻炼也能愈合。最终结果的最重要指标是物理治疗的开始时间。对于这种骨折，建议采用坚强内固定，但如果切开复位不太可能实现稳定性，则非手术措施更为可取。
