소아 상완골 과상부 골절에 대한 임상적 고찰 = Clinical Analysis of Supracondylar Fracture of the Humerus in Children

다국어 초록 (Multilingual Abstract)

In the pediatric age group, the supracondylar fracture of humerus is the second most common fracture after that of the forearm. But the supracondylar fracture of humerus in children has a greater rate of rereduction, nerve injury, surgical intervention, and poor results than any other type of extremity fracture.
Forty eight cases of 48 children with the supracondylar fracture of humerus who had been treated at the department of orthopaedic surgery, Chungnam National University Hospital from February, 1986 to January, 1991, were analyzed retrospectively for the methods of treatment and its results.
1. The mean age of the patients was 8.3 years, ranging from one to fourteen years. 26 boys and 22 girls with minimum six months follow-up were included in this sudy and the most of the causes of injuries were silp-down(45.8%) and fall-down from height(50.0%).
2. Of all fractures, the extension type was 46 cases(95.8%) and the flexion type was 2 cases(4.2%).
3. Accoding to the classification by Pirone et al., fractures were classificated to type Ⅰ in 2 cases, type Ⅱ-A in 6, type Ⅱ-B in 14 and type Ⅲ in 26 cases.
4. There were 8 cases of concomitant peripheral nerve injuries, radial nerve palsy in 6, ulnar nerve in 1 and median nerve in 1 case.
5. The treatment were consisted of closed reduction and casting in 10, closed reduction and percutaneous pinning in 20, and open reduction and multiple pinning in 18 cases with or without preoperative skeletal traction.
6. The clinical and radiological results were Excellent in 22(45.8%), Good in 13(27.1%), Fair in 8(16.7%) and Poor in 5(10.8%) cases, according to the criteria of Flynn.
7. The closed reduction and percutaneous pinnings of 20 cases were rated Excellent and Good results in 18(90.0%) cases and these results were superior to another methods of treatment.
So we concluded that the closed reduction and percutaneous pinnings was simple, safe and effective method of the treatment for the supracondylar fracture of the humerus in children. But it was technically difficult to reduce the displaced fracture satisfactory by closed manipulation and in these cases, the open reduction was still indicated.