Walløe A, Egund N, Eikelund L
Injury. 1985 Mar;16(5):296-9. doi: 10.1016/0020-1383(85)90127-5.
Of 70 supracondylar fractures of the humerus in children, 25 were treated by open reduction and internal fixation, 24 by closed manipulation and plaster and 21 by plaster-of-Paris only. Three of the fractures were operated on because of suspected vascular injury (with or without neurological symptoms), another seven because of instability and/or extreme swelling and 15 after unsatisfactory closed reduction. Traction was used in 3 of the 24 patients treated by closed methods and among the other 21, three fractures had to be manipulated twice. Three to six years after the injury, 6 of the 25 patients operated on had reduced flexion-extension and/or deformity exceeding 10 degrees. Five patients treated by closed reduction had reduced movements or deformity exceeding 10 degrees and three patients with originally undisplaced fractures had deformity exceeding 10 degrees. In this study the most severe fractures were selected for operation but, in spite of this, the results were better than for fractures treated by closed reduction and plaster. Based on this and previous studies, a plan suitable for most departments is suggested for the treatment of this fracture.
在70例儿童肱骨髁上骨折中，25例行切开复位内固定治疗，24例行闭合手法复位及石膏固定，21例仅用石膏固定。3例骨折因怀疑有血管损伤（伴有或不伴有神经症状）而接受手术，另外7例因不稳定和/或极度肿胀接受手术，15例因闭合复位效果不佳接受手术。在24例接受闭合治疗的患者中，3例使用了牵引，在另外21例中，有3例骨折不得不进行了两次手法复位。受伤3至6年后，25例接受手术的患者中有6例屈伸活动度减小和/或畸形超过10度。5例接受闭合复位治疗的患者活动度减小或畸形超过10度，3例最初无移位骨折的患者畸形超过10度。在本研究中，选择了最严重的骨折进行手术，但尽管如此，其结果仍优于闭合复位及石膏固定治疗的骨折。基于此项研究及以往研究，建议制定一个适用于大多数科室的该骨折治疗方案。
