Hohl H P, Wessel L, Waag K L
Kinderchirurgische Klinik, Klinikum Mannheim, Universität Heidelberg.
Unfallchirurgie. 1996 Oct;22(5):202-8. doi: 10.1007/BF02641221.
Hundred and twenty-eight supracondylar fractures of the humerus were studied retrospectively after an follow-up time of 4.3 years (1 to 17.8 years). In 87 cases (68%) the operative procedure was the closed reduction and percutaneous crossed-pin fixation for 19 fractures type III (56%). 22 fractures type II (76%) and 46 fractures type I (85%), whereas 41 fractures were treated by open reduction and crossed-pin fixation. The findings were evaluated according to "Flynn's criteria" leading to the following results: "excellent" 77 times (60.2%), "good" 44 times (34.4%) "fair" 3 times (2.3%) and "poor" 4 times (3.1%). Our results show that with approximately 50% of all fractures type III the treatment by closed reduction and percutaneous crossed-pin fixation leads to a very good long-term result. On the other hand, rotated or interponated fractures type I and II require an open reduction and crossed-pin fixation. Independent of the type of fracture, the closed reduction and percutaneous crossed-pin fixation should always be taken into consideration. Exceptions are open fractures and those with multiple fragments.
对128例肱骨髁上骨折患者进行了回顾性研究,随访时间为4.3年(1至17.8年)。87例(68%)患者采用了闭合复位经皮交叉克氏针固定术,其中Ⅲ型骨折19例(56%),Ⅱ型骨折22例(76%),Ⅰ型骨折46例(85%);41例患者采用切开复位交叉克氏针固定术。根据“弗林标准”对结果进行评估,结果如下:“优”77例(60.2%),“良”44例(34.4%),“可”3例(2.3%),“差”4例(3.1%)。我们的结果表明,对于约50%的Ⅲ型骨折,采用闭合复位经皮交叉克氏针固定术可取得非常好的长期效果。另一方面,Ⅰ型和Ⅱ型旋转或嵌入骨折需要切开复位交叉克氏针固定术。无论骨折类型如何,闭合复位经皮交叉克氏针固定术都应始终作为考虑的方法。开放性骨折和多块骨折除外。