De Boeck H, De Smet P, Penders W, De Rydt D
V.U.B., University Hospital, Brussels, Belgium.
J Pediatr Orthop. 1995 Jul-Aug;15(4):444-8. doi: 10.1097/01241398-199507000-00006.
We reviewed the cases of 13 children with supracondylar elbow fractures with impaction of the medial wall. The displacement was underestimated in two patients and treated as a minimally displaced fracture by simple immobilization without reduction, resulting in a cubitus varus deformity. In one patient, the correct diagnosis was made, but treatment by reduction was refused by the parents. A loss of carrying angle of 10 degrees resulted from this. Two patients referred for treatment of cubitus varus were treated elsewhere for the initial injury: one by reduction and plaster cast immobilization and the other by simple immobilization without reduction. Two children with a supracondylar fracture with buckling of the medial condyle without prominent deformity were not reduced and showed no deformity at follow-up. Six children with collapse of the medial condyle, treated by closed reduction and percutaneous pinning, all had a normal carrying angle at follow-up. We believe that this method is safe to prevent varus angulation.
我们回顾了13例伴有内侧壁嵌插的肱骨髁上骨折患儿的病例。两名患者的移位情况被低估，被当作无移位骨折单纯固定而未进行复位治疗，导致肘内翻畸形。一名患者诊断正确，但家长拒绝复位治疗，由此导致提携角丧失10度。两名因肘内翻前来治疗的患者最初受伤时在其他地方接受了治疗：一名进行了复位及石膏固定，另一名单纯固定未复位。两名内侧髁屈曲但无明显畸形的肱骨髁上骨折患儿未进行复位，随访时未出现畸形。六名内侧髁塌陷的患儿接受了闭合复位及经皮穿针固定治疗，随访时提携角均正常。我们认为这种方法对于预防内翻成角是安全的。
