小児上腕骨か骨折の回旋転位についての考察

Abstract

One hundred and sixty-seven cases of supracondylar fractures of the humerus in children were reviewed and discussed concerning rotation of the distal fragment. In most cases the distal fragments showed internal rotation around the lateral axis (78.1%) caused at the time of injury. Care must be taken to prevent redislocation during immobilization in plaster after closed reduction, and correction must be made before the fracture achieves stability in cases where re-dislocation of rotation with medial tilt is visible on X-ray films. An over-head pin traction is an effective method to prevent varus deformity. The authors insist on anatomical reduction of the fracture. Cubitus varus results from incorrected or redislocated rotation which leads to no contact on the medial side between the proximal and distal fragments of the humerus. Consequently the distal fragment may tilt medially. If the fracture line crosses the fossa olecrani, rotation of the distal fragment may result in a narrowing of the space and incongruity of the humerus and ulna. Consequently loss of motion to some degree remains long-Lasting.