关键词: 肱骨, 外科治疗, 内翻畸形, Humerus, cubitus varus

Abstract: Objective There is an uncommon subset of supracondylar humeral fractures in children that are so unstable they can displace into both flexion and extension. The purposes of this study were to describe this subset of supracondylar fractures and to report a technique of opened reduction and percutaneous pinning for their treatment.Methods In a review of 8 severely displaced displaced supracondylar humeral fractures in children treated operatively at our institution, we identified eight that were completely unstable with documented displacement into both flexion and extension as seen on fluoroscopic examination with the patient under anesthesia. We used a technique for opened reduction and fixation of these fractures, and then we assessed fracture-healing and complications from the injury and treatment.Results All eight fractures were treated satisfactorily with opened reduction and percutaneous pinning. None of the patients had a nonunion, cubitus varus, malunion, additional surgery, or loss of motion.Conclusions In severely displaced supracondylar fractures in children, multidirectional instability results in displacement into flexion and/or extension. This fracture may be classified as type IV according to the Gartland system, Severely displaced supraacondylar f racture of the humerus still needs open reduction These fractures can be treated successfully with a technique of opened reduction and percutaneous pinning. hard intermal and external fixation ,early elbow joint functional training are the important measures 。