Surd Adrian, Muresan Rodica, Ciongradi Carmen Iulia, Sur Lucia Maria, Ardelean Lucia Raluca, Usatiuc Lia Oxana, Snakovszki Kriszta, Munteanu Camelia, Sârbu Ioan
Pediatric Surgery and Orthopedics, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, 400347 Cluj-Napoca, Romania.
Pediatric Surgery and Orthopedics, Emergency Children Hospital Cluj-Napoca, 400177 Cluj-Napoca, Romania.
Children (Basel). 2025 Apr 25;12(5):556. doi: 10.3390/children12050556.
Supracondylar humeral fractures are the most common type of elbow fractures in children. The treatment methods vary depending on the type of fracture (Gartland classification), which can be conservative or surgical. There is no clear consensus or guidelines to dictate the treatment of complicated supracondylar humeral fractures (Gartland types II and III). Gartland type II and III fractures are most frequently treated with closed reduction and percutaneous Kirchner-wire pinning or open reduction with K-wire pinning, depending on the degree of displacement and the orthopedic surgeon's preference. Most studies recommend avoiding open reduction because of prolonged hospitalization and higher rates of complications. Orthopedic surgeons have different opinions regarding the Kirschner pin placement technique. Studies suggest that only lateral pinning is safe and effective, but medial and lateral pinning is proven to give more stability; there is always a risk of iatrogenic ulnar nerve damage during surgery. Modern treatment of supracondylar humeral fracture in children should focus on minimally invasive techniques and avoid open reduction, when possible, to ensure the best outcome for the patients. This scoping review's purpose is to gather the available information on the topic in one place and to underline the lack of clear protocols.
肱骨髁上骨折是儿童肘部骨折最常见的类型。治疗方法因骨折类型（Gartland分型）而异，可采用保守治疗或手术治疗。对于复杂的肱骨髁上骨折（GartlandⅡ型和Ⅲ型），目前尚无明确的共识或指南来指导治疗。GartlandⅡ型和Ⅲ型骨折最常根据移位程度和骨科医生的偏好，采用闭合复位经皮克氏针固定或切开复位克氏针固定。大多数研究建议避免切开复位，因为住院时间延长且并发症发生率较高。骨科医生对克氏针置入技术有不同意见。研究表明，仅外侧穿针是安全有效的，但内侧和外侧穿针被证明能提供更大的稳定性；手术过程中始终存在医源性尺神经损伤的风险。儿童肱骨髁上骨折的现代治疗应注重微创技术，并尽可能避免切开复位，以确保为患者带来最佳预后。本综述的目的是将该主题的现有信息集中在一起，并强调缺乏明确的方案。
