["High" supracondylar fracture of the humerus in children.].
Fractures of the distal part of the humerus in children where the line of fracture is higher than in typical supracondylar or transcondylar fractures, i. e. on the borderline of the distal metaphysis and diaphysis, differ from classical supracondylar and diaphyseal fractures and call also for a different therapeutic approach. In these "high" supracondylar fractures the risk of feared rotation of the peripheral fragment with a tendency of varus deformity and the formation of a peak-shaped process of the rotated metaphysis preventing flexion in the joint is smaller, however, the fragments have a low stability due to extensive damage of the periostium. Closed reduction reposition is not successful as a rule and classical percutaneous fixation by means of two crossed Kirschner wires, usually successful in supracondylar fractures, also fails. In several of the authors' patients it was found that adequate retention of fragments is ensured by modified percutaneous intramedullary elastic osteosynthesis, as described by Prévot-Métaizeau. Key words: fracture, humerus, supracondylar fracture.
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Klinika detské chirurgie IPVZ, Praha.