[The supracondylar fracture of the humerus in children (author's transl)].
To find out the cause of posttraumatic varus and valgus deformity of the elbow a long-term follow-up examination of 183 dislocated and 20 undislocated supracondylar extension-fractures of the humerus was done. There were different methods of treatment: In most of the cases closed reduction was performed and fixation in acute angle-plaster or by percutaneous radial or radial and ulnar wires. 75% showed radiologically and 55% clinically an alteration of the carrying angle. The clear reason for this deformity was a rotation displacement, which leads in oblique fractures directly, in transverse fractures--caused by an instability--indirectly seldom to a valgus, in most of the cases to a varus deformity of the elbow. A special quotient to judge the rotation displacement is presented: the rotation failure quotient (rfq). There is no influence of lateral compression to the carrying angle. Lateral tilting is in any case a result of rotation displacement. Growth disturbance after supracondylar fractures is possible without lesion of the epiphysial plate: but as growth disturbances are seldom and their extent small, they are of no significant clinical importance. Extension displacement of the distal fragment will be spontaneously corrected in ca. 80% of all cases during the further growth. The clinical importance of posttraumatic deformities and the primary management to avoid them is discussed. The crossed percutaneous rotation-stable wire osteosynthesis is recommended as the best way of treatment. For all kinds of treatment the challenge is asked to avoid the ventral spur as a sign of rotation till consolidation of the fracture. By correct reposition in all other planes complicated measurements and reflections, as for instance the alpha-angle by Baumann, oblique or transverse fracture, pro- or supination of the forearm during fixation a.o. are unnecessary.
D000293:Adolescent; D000886:Anthropometry; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000592:standards*; D006801:Humans; D006810:Humeral Fractures / Q000628:therapy*; D007223:Infant; D007592:Joint Diseases / Q000209:etiology; D008297:Male; D008670:Metals; D009984:Orthopedic Fixation Devices; D011859:Radiography
D008670:Metals
Die supracondyläre Humerusfraktur im Kindesalter.