Læknablaðið - 15.11.1984, Side 20

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LÆKNABLAÐID
upparmsslagæð og miðtaug klemmdust á milli
brotenda. í einu pessara tilvika var fram-
kvæmd aðgerð 10 vikum eftir áverkann vegna
viðvarandi truflunar á starfsemi miðtaugar. í
ljós kom að taugin var vaxin föst við beinvef á
milli brotenda og var hún losuð frá við aðgerð
og lagaðist taugastarfsemin algjörlega á næstu
mánuðum.
Nidurstödur pessarar rannsóknar má orda á
pessa leið: Óblóðug rétting og festing með
mjúkum ytri umbúðum er góð og örugg með-
ferð hjá börnum með brot á upphandlegg rétt
ofan leggjarhnúa. í þeim tilvikum, þar sem
blóðrásartruflun er fyrir hendi eða að viðun-
andi brotstaða næst ekki, teljum við óhjá-
kvæmilegt að framkvæma innri festingu,
ýmist með eða án blóðugrar réttingar.
SUMMARY
Supracondylar fracture of the humerus in 208
children attending the Emergency Clinic of the City
Hospital, Reykjavik, Iceland in 1971-1979.
Seventy-five children with dislocated supracondy-
lar fractures of the humerus were examined retro-
spectively after a follow-up period of 2-12 years. All
fractures were healed and no serious complications
were found.
Tilting of the distal fragment into varus or valgus
is the main reason for change in carrying angle.
The results were excellent or good in seventy
cases, fair in five and no poor case was found.
Closed reduction is recommended, but open
reduction and fixation of the fragments with Kirsch-
ner-wires may become necessary with vascular and
neural complication, or where varus or valgus tilting
of the distal fragment cannot be reduced.
A very rare complication of dislocation of the
median nerve and the brechial artery was seen in
three cases.
HEIMILDIR
1) Blount WP, Schulz I, Cascidy RH: Fractures of
the elbow in children. JAMA 1951; 146: 699-704.
2) Henrikson B. Supracondylar fracture of the
humerus in children. Acta Chir Scand 1966;
suppl 369: 1-72.
3) Valhanen V, Aalto K. Supracondylar fracture of
the humerus in children. A long-term follow-up
study of 107 cases. Acta Orthop Scand 1978; 49:
225-33.
4) Blount WP. Fractures in children. Baltimore,
Williams & Wilkins, 1955.
5) Tachdjian MO: Pediatric orthopedics. Phila-
delphia, Saunders, 1972.
6) Danilsson L, Petterson H. Open reduction and
pin fixation of severely displaced supracondylar
fractures of the humerus in children. Acta
Orthop Scand 1980; 51: 249-55.
7) Watson-Jones R. Fractures and joint injuries.
4th ed. Baltimore. Williams & Wilkins, 1962.
8) Charnley J. The closed treatment of common
fractures. Edinghurg: Livingstone, 1963.
9) Sharrard WJW. Paediatric orthopaedies and
fractures. Oxford, Blackwell, 1971.
10) Swenson AL. The treatment of supracondylar
fractures of the humerus by Kirschner-wire
transfixation. J Bone Joint Surg Am 1948; 30-A:
993-7.
11) Ramsey RH, Griz J. Immediate open reduction
and internal fixation of severely displaced
supracondylar fractures of the humerus in
children. Clin Orthop 1973; 90: 231-2.
12) Dunlop J. Transcondylar fractures of the hu-
merus in childhood. J Bone Joint Surg 1939; 21-
59-73.
13) Dodge HS: Displaced supracondylar fractures
of the humerus in children — treatment by
Dunlop’s traction. J Bone Joint Surg Am 1972;
54-A: 1408-18.
14) Shifrin PG, Gehring HW, Iglesias LJ: Open
reduction and internal fixation of displaced
supracondylar fractures of the humerus in
children. Orghop Clin North Am 1976; 7: 573-
81.
15) Arino VL, Lluch EE, Ramirez AM, Ferrer J,
Rodriguez L, Baixauli F. Percutaneous fixation
of supracondylar fractures of the humerus in
children. J Bone Joint Surg Am 1977; 59-A: 914-
6.
16) Lagerange J, Riault P. Fractures supra-condyli-
ennes. Rev Chir Orthop 1962; 48: 337-446.
17) Siris IE. Supracondylar fracture of the humerus.
An analysis of 330 cases. Surg Gynecol Obstet
1939;68:201-22.
18) Madsen E. Supracondylar fractures of the hu-
merus in children. J Bone Joint Surg Br 1955;
37-B: 241-5.
19) El-Sharkawi AH, Fattah HA: Treatment of
displaced supracondylar fractures of the humer-
us in children in full extension and supination. J
Bone Joint Surg Br 1965; 47-B: 273-9-
20) D’Ambrose RD. Supracondylar fractures of the
humerus — prevention of cubitus varus. J Bone
Joint Surg Am 1972; 54-A: 60-6.
21) Flynn JC, Matthews JG, Benoit RL. Blind
pinning of displaced supracondylar fractures of
the humerus in children. Sixteen year’s experi-
ence with long-term follow-up. J Bone Joint
Surg Am 1974; 56-A: 263-72.