Rumlova E, Vogel E
Z Kinderchir. 1983 Apr;38 Suppl:48-50. doi: 10.1055/s-2008-1063073.
Dislocated supracondylar femoral fractures are usually transverse fractures and are unstable. In our opinion the primary treatment of these fractures should be surgical in order to save the patient a protracted healing period. Osteosynthesis using a straight plate is impossible, as the distal fragment is too short. Condylar plates are contraindicated and angular plates have too little stability. We feel that intramedullary pins are unsuitable in children. They provide too little stability when the distal fragment is short. Up to now we have achieved the best results with external fixation. Slipped epiphyses and epiphyseal fractures do not present problems as far as the surgical procedure is concerned (removal of the displaced periosteum, repositioning and compression). Healing is not delayed. The long-term results are poor, however, due to premature closure of the damaged epiphyseal plate.
股骨髁上骨折脱位通常为横行骨折,且不稳定。我们认为,这些骨折的主要治疗方法应是手术治疗,以便为患者节省漫长的愈合期。使用直板进行骨固定是不可能的,因为远端骨折块太短。髁钢板是禁忌的,而角钢板稳定性不足。我们认为髓内针不适用于儿童。当远端骨折块较短时,其提供的稳定性不足。到目前为止,我们采用外固定取得了最佳效果。就手术操作而言(去除移位的骨膜、复位和加压),骨骺滑脱和骨骺骨折不存在问题。愈合不会延迟。然而,由于受损骨骺板过早闭合,长期效果较差。