[Classification of humeral supracondylar fractures in children.].
The existing classifications of supracondylar fractures of humerus in children are not adequate and do not reflect the variability of this fracture, its requirements as for diagnosis and method of treatment. The article presents a list of classification published in literature starting from the Kocher classification of 1896 until the present schemes. These classifications divide supracondylar fractures into extension or flexion ones or according to the extent of displacement of fragments into 3-4 types. Only Wilkins mentions a different type, metadiaphyseal fracture, the treatment of which differs from usual procedures. The article present the author's own classification of supracondylar fractures breaking this injury down to 6 types. Type 0 is a fracture without displacement, type 1 is an extension fracture, type 2 a flexion one, type 3 an indifferent one, type 4 is a fracture with a high fracture line on the border of metaphysis and diaphysis and type 5 is an atypical supracondylar fracture. Typ 5 is subdivided into subtype a) oblique fracture with one of the condylar pillars broken, suptype b) a supracondylar fracture with a broken metaphyseal supraphyseal fragment and subtype c) which is intercondylar fracture with a dissociated displacement where the condylar body is not displaced and neither the articular congruency not the continuity of the physis is impaired. The author shows incidence of individual types on a smaller group of patients. He briefly recommends the suitable treatment for individual types. The mission of the new classification is to identify different forms of supracondylar fracture which require an approach as concerns diagnosis and the treatment in particular. Key words: humerus, supracondylar fracture, children's fractures, classification.
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Centrum detské traumatologie, Klinika detské chirurgie, Fakultní Thomayerova nemocnice, Praha.