Dowd G S, Hopcroft P W
Injury. 1979 May;10(4):297-303. doi: 10.1016/0020-1383(79)90047-0.
Eighty cases of supracondylar fracture of the humerus at the elbow in children have been analysed. The post-reduction radiograph of the fracture was classified depending on the residual deformity present and related to the loss of carrying angle and cubitus varus deformity at the time of follow-up. Fifty-four percent of the displaced fractures showed a loss of carrying angle greater than 5 degrees, and of these 23 per cent developed cubitus varus deformity. Eighty-five per cent of those cases with a loss of carrying angle greater than 10 degrees showed either residual tilt or medial rotation on the post-reduction radiograph. All cases in which there was residual medial tilt after manipulation and 40 per cent of those with medial rotation on the post-reduction radiograph developed cubitus varus. In our series, there was no evidence of epiphyseal injury causing the deformity and in none of the cases was the deformity progressive. It is suggested that, in order to reduce the incidence of varus deformity in suprocondylar fractures, open reduction and internal fixation is indicated in those fractures in which tilt or medial rotation cannot be reduced by conservative means.
对80例儿童肱骨髁上骨折病例进行了分析。根据骨折复位后的X线片上存在的残余畸形进行分类，并与随访时提携角的丢失和肘内翻畸形相关。54%的移位骨折显示提携角丢失大于5度，其中23%出现肘内翻畸形。提携角丢失大于10度的病例中，85%在复位后的X线片上显示有残余倾斜或内旋。手法复位后有残余内侧倾斜的所有病例以及复位后X线片上有内旋的病例中的40%出现了肘内翻。在我们的系列病例中，没有证据表明骨骺损伤导致畸形，且无一例畸形呈进行性发展。建议为了降低髁上骨折肘内翻畸形的发生率，对于那些不能通过保守方法矫正倾斜或内旋的骨折，应行切开复位内固定。
