Williamson D M, Cole W G
Royal Children's Hospital, Melbourne, Australia.
Injury. 1993 Apr;24(4):249-52. doi: 10.1016/0020-1383(93)90180-e.
The long-term results after the manipulation and strapping in flexion of selected extension supracondylar fractures of the humerus were evaluated in 43 children. Reduced fractures that were stable when immobilized in approximately 110 degrees of flexion, without producing circulatory obstruction, were treated in this manner. After a minimum review of 4 years, 95 per cent of the children had an excellent or good range of elbow motion and 88 per cent had excellent or good elbow alignment. No child had Volkmann's ischaemic contracture. Five children had cubitus varus which was due to malunion in three, but was unrelated to the treatment of the supracondylar fracture in two children. If these two latter children were excluded then excellent or good alignment was observed in all children who had a Baumann (humerocapitellar) angle of 80 degrees or less at the time of reduction and 84 degrees or less 10 days after the fracture. We concluded that manipulation and strapping in flexion was suitable for approximately 60 per cent of children with isolated displaced supracondylar fractures of the humerus.
对43例儿童肱骨髁上伸展型骨折选择屈曲位手法复位及石膏固定后的远期疗效进行了评估。对于复位后骨折在大约110度屈曲位固定时稳定且未造成循环障碍的患儿，采用这种治疗方式。经过至少4年的随访，95%的患儿肘关节活动范围为优或良，88%的患儿肘关节对线为优或良。无患儿发生Volkmann缺血性挛缩。5例患儿出现肘内翻，其中3例是由于骨折畸形愈合，但有2例与髁上骨折的治疗无关。如果排除这2例患儿，那么所有在复位时Baumann（肱骨头）角小于80度且骨折后10天小于84度的患儿，其肘关节对线均为优或良。我们得出结论，屈曲位手法复位及石膏固定适用于大约60%的单纯移位型肱骨髁上骨折患儿。
