Würfel A M, Voigt A, Linke F, Hofmann von Kap-herr S
Klinik und Poliklinik für Kinderchirurgie, Johannes-Gutenberg-Universität Mainz.
Unfallchirurgie. 1995 Apr;21(2):70-6. doi: 10.1007/BF02588733.
From 1984 to 1992 153 children were treated at the pediatric surgical department of the University of Mainz, of whom 19 had fractures of the radius, 9 of the ulna and 125 had a combination of both in the diaphysis of the forearm. Factors like patient's age, type of fracture and therapeutic methods were analyzed. One hundred and forty-one children were treated conservatively, 12 by operation. One hundred and one of these patients were healthy, when discharged (about 8 weeks after accident). Follow-up was possible in 69 cases. We found that occasional a remaining dislocation angle does not impair function: in 65 cases the result was "good" and "very good", but only "moderate" in 4 cases. These 4 children had been treated conservatively by reposition and plaster cast; 2 of these 4 children showed bone reconstruction without dislocation. Twenty-two of the 56 X-ray follow-up's showed persisting dislocation. To prevent functional problems (2 of our cases) it is essential to obtain a very exact reposition of diaphyseal forearm fractures. Therefore we would recommend a more generous indication for operation, preferably using elastic-stable Nancy pins.
1984年至1992年期间,美因茨大学小儿外科共治疗了153名儿童,其中19名桡骨骨折,9名尺骨骨折,125名在前臂骨干处合并有桡骨和尺骨骨折。对患者年龄、骨折类型及治疗方法等因素进行了分析。141名儿童接受保守治疗,12名接受手术治疗。其中101名患者出院时(事故发生约8周后)情况良好。69例患者获得随访。我们发现,偶尔存在的残余脱位角并不影响功能:65例结果为“良好”和“非常好”,但4例仅为“中等”。这4名儿童接受了复位及石膏固定的保守治疗;其中2名儿童出现了无脱位的骨重建。56例X线随访中有22例显示持续脱位。为防止出现功能问题(我们的病例中有2例),精确复位前臂骨干骨折至关重要。因此,我们建议扩大手术指征,最好使用弹性稳定的南锡针。