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CAUSE AND MECHANISMS OF INJURY Hasler contends that 96 per cent of all supracondylar fractures of the humerus are extension-type injuries that occur during falls onto the outstretched hand, while between 1 and 2 per cent occur through falls onto the olecranon with the elbow flexed. It is unclear how these figures are reached, because Hasler describes no study into the incidence and mechanism of such injuries. However, Wilkins, a much quoted and well respected author on the subject, lends support to this notion, claiming that between 90 and 95 per cent of these injuries result from extension and the rest from flexion. Extension type injuries occur when the elbow is in a position of hyperextension with the olecranon acting as a fulcrum across which the humerus breaks. The peak age of injury is usually quoted as between four and eight years, This distribution is explained by Nork eta/: bone is weaker at this stage of development and this, and the ligamentous laxity predisposing the elbow to hyperextension, render the elbow friable. Many ot these injuries occur during play, sport or during falls from a height. This again fits with the stage of development, this time from a social perspective, as children of this age have little perception of danger and engage In risky and adventurous activities and play. Interestingly. Waltzman et a/ find that, even with heightened parental supervision, the incidence of injury was the same. It seems, therefore, that it is 'natural ' for children to sustain this kind of trauma at this age. |
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chemistry2228
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2楼2011-04-29 12:18:01
chemistry2228
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chemistry2228
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4楼2011-04-29 12:40:50
