1、The following is a summary of the recommendations in the AAOS clinical practice guideline, The Treatment of Pediatric Supracondylar Humerus Fractures. This summary does not contain rationales that explain how and why these recommendations were developed nor does it contain the evidence supporting th
2、ese recommendations. All readers of this summary are strongly urged to consult the full guideline and evidence report for this information. We are confident that those who read the full guideline and evidence report will see that the recommendations were developed using systematic evidence-based pro
3、cesses designed to combat bias, enhance transparency, and promote reproducibility. 以下是 AAOS（美国骨科医师协会）临床实践指南中关于小儿肱骨髁上骨折的推荐规范的摘要。这个摘要不包含解释这些推荐规范是如何以及为什么是成熟的，也不包含证据支持这些推荐规范。所有阅读这个摘要的读者被强烈要求查阅完整的指南和证据报告的资料。我们坚信,那些阅读完整的指南和证据报告的将会看到,建议使用以证据为基础的系统开发过程旨在对抗偏见,提高透明度,促进再现性。This summary of recommendations is no
4、t intended to stand alone. Treatment decisions should be made in light of all circumstances presented by the patient. Treatments and procedures applicable to the individual patient rely on mutual communication between guardian and physician as well as other healthcare practitioners. 这个推荐规范的摘要信息并不是孤立
5、的。治疗决策应该取决于病人的所有情形。治疗方法和程序适用于个别病人依靠监护人和医师相互之间的交流，正如其他医疗保健从业者一样。1. We suggest nonsurgical immobilization of the injured limb for patients with acute (e.g. Gartland Type I) or non displaced pediatric supracondylar fractures of the humerus or posterior fat pad sign我们建议给予急症病人的受伤肢体(如Gartland I型) 或无移位的儿童肱
6、骨髁上骨折或后脂肪垫征象的采取非手术固定。Strength of Recommendation: Moderate 建议强度：中等2. We suggest closed reduction with pin fixation for patients with displaced (Gartland Type II and III, and displaced flexion) pediatric supracondylar fractures of the humerus.我们建议对于移位的小儿肱骨髁上骨折如 Gartland II 型 and III 型,屈曲型移位的病人采取闭合复位克氏
7、针内固定。 Strength of Recommendation: Moderate 建议强度：中等 3. The practitioner might use two or three laterally introduced pins to stabilize the reduction of displaced pediatric supracondylar fractures of the humerus. Considerations of potential harm indicate that the physician might avoid the use of a medi
8、al pin. Strength of Recommendation: Weak 建议强度：弱4. We cannot recommend for or against using an open incision to introduce a medial pin to stabilize the reduction of displaced pediatric supracondylar fractures of the humerus. Strength of Recommendation: Inconclusive 建议强度：不确定 5. We are unable to recomm
9、end for or against a time threshold for reduction of displaced pediatric supracondylar fractures of the humerus without neurovascular injury. Strength of Recommendation: Inconclusive 建议强度：不确定 6. The practitioner might perform open reduction for displaced pediatric supracondylar fractures of the hume
10、rus with varus or other malposition after closed reduction. Strength of Recommendation: Weak 建议强度：弱7. In the absence of reliable evidence, the opinion of the work group is that emergent closed reduction of displaced pediatric supracondylar humerus fractures be performed in patients with decreased pe
11、rfusion of the hand. Strength of Recommendation: Consensus 建议强度：共识 8. In the absence of reliable evidence, the opinion of the work group is that open exploration of the antecubital fossa be performed in patients who have absent wrist pulses and are underperfused after reduction and pinning of displa
12、ced pediatric supracondylar humerus fractures. Strength of Recommendation: Consensus 建议强度：共识 9. We cannot recommend for or against open exploration of the antecubital fossa in patients with absent wrist pulses but with a perfused hand after reduction of displaced pediatric supracondylar humerus frac
13、tures. Strength of Recommendation: Inconclusive 建议强度：不确定10. We are unable to recommend an optimal time for removal of pins and mobilization in patients with displaced pediatric supracondylar fractures of the humerus. Strength of Recommendation: Inconclusive 建议强度：不确定11. We are unable to recommend for
14、 or against routine supervised physical or occupational therapy for patients with pediatric supracondylar fractures of the humerus. Strength of Recommendation: Inconclusive 建议强度：不确定12. We are unable to recommend an optimal time for allowing unrestricted activity after injury in patients with healed
15、pediatric supracondylar fractures of the humerus. Strength of Recommendation: Inconclusive 建议强度：不确定13. We are unable to recommend optimal timing of or indications for electrodiagnostic studies or nerve exploration in patients with nerve injuries associated with pediatric supracondylar fractures of the humerus. Strength of Recommendation: Inconclusive 14. We are unable to recommend for or against open reduction and stable fixation for adolescent patients with supracondylar fractures of the humerus. Strength of Recommendation: Inconclusive 建议强度：不确定
