Nacht J L, Ecker M L, Chung S M, Lotke P A, Das M
Clin Orthop Relat Res. 1983 Jul-Aug(177):203-9.
During the period from 1973 to 1978, 38 children with displaced supracondylar fractures of the humerus were treated at The Children's Hospital of Philadelphia by closed reduction and percutaneous pin fixation. The technical details of the procedure include (1) reduction under general anesthesia with adequate relaxation; (2) insertion of crossed pins from the medial and lateral side with the elbow in acute flexion; (3) and intraoperative clinical and roentgenographic examination of the pinned fracture with the elbow in extension to determine the adequacy of the reduction, with particular attention to the carrying angle. By Flynn's criteria acceptable results were obtained in 19 of the 25 patients studied. Three results were unacceptable due to cubitus varus of 2 degrees, 5 degrees, and 10 degrees, respectively, and three to loss of flexion. Although rotational malalignment occurred in 19 patients, as manifested by a change in shoulder rotation, in no patient was it clinically significant, either cosmetically or functionally. There were no neurologic or vascular complications from the treatment. This is a safe and reliable technique for obtaining and maintaining an excellent reduction in this difficult fracture while preserving vascular function.
1973年至1978年期间，费城儿童医院对38例肱骨髁上移位骨折患儿采用闭合复位经皮穿针固定治疗。该手术的技术细节包括：（1）在全身麻醉且充分松弛的状态下进行复位；（2）在肘关节急性屈曲时从内侧和外侧插入交叉克氏针；（3）术中在肘关节伸直位对固定后的骨折进行临床和X线检查，以确定复位是否充分，尤其要注意提携角。根据弗林标准，在研究的25例患者中，19例取得了可接受的结果。3例结果不可接受，分别是肘内翻2度、5度和10度，3例是屈曲功能丧失。尽管19例患者出现了旋转畸形，表现为肩部旋转改变，但在外观或功能上均无临床意义。治疗过程中未出现神经或血管并发症。这是一种安全可靠的技术，可在保留血管功能的同时，对这种难复性骨折实现并维持良好的复位。
