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幼若家兎의 상완골 과상골절에 起因한 내반기 發生에 關한 實驗的 硏究

An Experimental Study on Cubitus Varus Deformity Following Supracondylar Fractures of the Humerus in Baby Rabbits.

최신의학 1963년 6권 6호 p.83 ~ 91
윤경현,
소속 상세정보
윤경현 ( Yun Kyoung-Hyun ) - 서울대학교 의과대학 정형외과학교실

Abstract


Change in the carrying angle of the elbow is the most common complication with which we have to deal in the treatment of suppacondylar fractures of the humerus. Many reports have been published in which the incidence of carrying-angle change after supracondylar fractures of the humerus had beer ` as high as 57 per cent, and the average in most groups has been approximately 30 per cent.
Lyman Smith reported on an end-result study of fifty supracondylar fractures of the humerus at the Boston City Hospital, and concluded that change in the carrying angle of the elbow after supracondylar fractures of the humerus is caused by medial or lateral angulation of the distal fragment.
Brewster and Karp examined eight cases of cubitus varus deformity and found that clinical measure- , ments of the length of the outside of the arm exceeded those of the inside by one-quarter to three-quarters of an inch in six. They concluded that this had been caused by stimulation of the external epicondylar and capitellar epiphyses.
In 1960, the anther examined a case: A seven year-old male had trauma on his left elbow in flexion ´ position. Since that time, he had been complaining of local pain, swelling and disability of his left elbow joint. And he showed infraction on lateral supracondylar region of his left humerus without displacement in X-ray- pictures. Patient had been treated by long arm cast for four weeks, and physical therapy for one week after removing of his long arm cast. The elbow joint showed slight cubitus varus deformity which has been increasing with growth.
The purpose of this experiment is that growth disturbance can be a cause of change in the carrying angle.
All experiments were carried out on rabbits 30 to 35 days old, weighing 500 to 700 grams, divided into three groups.
The first group of rabbits were fractured at medial supracondylar region by drilling with Kirschner--wire of which the diameter and the length were 2 millimeters respectively.
For the second group of rabbits a fracture was imposed in a similar manner at lateral supracondylar region of the humerus.
The third group of rabbits were fractured in a similar manner at both ´medial and lateral supracondylar regions of the humerus.
Rabbits of the each group were examined radiologically one and two months after fractures, and the changed angle was measured, that was formed by the lines joining the mid-point of the end of the humerus, and the mid-point of the humeral neck as located by measuring with the mid-point of the fracture site of supracondylar region of the humerus.
The results obtained are summarized as follows;
1) The group of rabbits which were fractured at medial half of supracondylar region ´showed the increased physiological cubitus valgus caused by overgrowth of the medial half of acondyle of the humerus.
2) The group of rabbits which were fractured at lateral half of supracondyle showed the decreased physiological cubitus valgus caused by overgrowth of lateral half of the condyle of the humerus.
) The group of the medial half of the distal epiphysis of the humerus was arrested more frequently than that of the lateral half when the fracture was imposed in a similar manner at both medial and lateral supracondyle.
4) The group of rabbits which were fractured in a similar manner at both medial and lateral supracondyle of the humerus, showed overgrowth of both medial and lateral condyles, but the growth of the medial half of the distal epiphyses of the humerus was arrested ´more frequently than ´that of the lateral half, and the growth was so extensive that the charge of the physidogical cubitus valgus angle was decreased.

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