Hart G M, Wilson D W, Arden G P
Injury. 1977 Aug;9(1):30-4. doi: 10.1016/0020-1383(77)90046-8.
A series of supracondylar fractures of the humerus in children is presented. The majority was reduced by closed manipulation. The difficult fractures were defined as those in which adequate reduction either could not be achieved by manipulation or was not maintained, or those in which neurological or vascular complications occurred. Such cases were treated by open reduction and internal fixation. The results were assessed with regard to loss of elbow movement, deformity and symptoms. The results of the operative series were comparable with those achieved by closed manipulation in the easier cases. No secondary corrective procedures were necessary. It is concluded that closed manipulation should be used routinely as the method of treatment for supracondylar fractures of the humerus in children, except in the difficult case, for which operative treatment should be undertaken. Stiffness or deformity does not follow open reduction and internal fixation.
本文报告了一系列儿童肱骨髁上骨折病例。大多数骨折通过闭合手法复位。难复性骨折定义为：无法通过手法复位达到充分复位或复位后无法维持，或伴有神经或血管并发症的骨折。此类病例采用切开复位内固定治疗。对肘关节活动度丧失、畸形及症状等方面进行了结果评估。手术治疗组的结果与较简单病例中闭合手法复位的结果相当，无需二次矫正手术。结论是，儿童肱骨髁上骨折除难复性病例需行手术治疗外，应常规采用闭合手法复位作为治疗方法。切开复位内固定不会导致关节僵硬或畸形。
