摘要
作者分析了本院1993年～1996年中资料完整的儿童肱骨髁上骨折328例，主要采用闭合复位，石膏外固定306例（93．3％），按朱盛修对肱骨髁上骨折的评定标准，肘屈伸功能优良率达97．3％，但肘内翻发生率仍较高。作者认为：治疗儿童肱骨髁上骨折的首选方法为闭合整复和石膏外固定，因其保留了良好的肘关节屈伸功能。同时，作者还分析了神经、血管合并损伤的处理及时内翻的形成原因。认为：神经损伤不必早期手术探查；有血循环障碍者应及时手法复位，经2～6小时短时间观察，无好转者应及时手术探查血管。术中发现血管等软组织嵌夹于骨折端，是妨碍手法复位，影响血循环恢复的主要原因。尺偏型损伤中尺侧骨皮质的压缩、缺损是形成肘内翻的病理基础。
In this study authors reviewed 328 cases of humerus supracondylar fracture during 1993~ 1996. Fost most of them,the closed reduction and immobilization with plaster of Paris was employed. The results were judged with Zhu Shengxiu'S Criteria. The excellent or good results (97. 3 % ) were obtained in flex -extension range of move ment in elbow. However,the rate of cubitus virus was high. The authors believe that the closed reduction and immobilization with plaster are the first choices for most of supracondylar fracture,because there may be no loss or minimal loss in flex - extension range of movement afterwards. For the cases with nerve damage, surgery is not necessary at the early stage. For the vascular damage,a closed reduction must be done as soon as posslble owing to the fact that the common cause of vascular damage is displacement of fracture. If the circulation is not irnproved within 2~6 hours,an exploring operation must be performed. In addition,authors assure that the cause of cubitus virus is compact or defect of medial cortical bone in medial displacement of fracture.
