骨科英文书籍精读（104）｜肱骨内上髁分离（2）
Treatment
Minor displacement may be disregarded. This is an extra-articular fracture, so the elbow can be mobilized as soon as the child wishes.
If the epicondyle is trapped in the joint it must be freed. Manipulation with the elbow in valgus and the wrist hyperextended (to pull on the flexor muscles) may be successful; if this fails, the joint must be opened (the ulnar nerve must be visualized and protected) and the fragment retrieved and fixed back in position.
Displaced fractures which are not trapped in the joint usually do not need to be operated upon: however, if there is valgus instability (because the medial collateral ligament complex is attached to the fragment) then reduction and pinning is recommended.
Complications
EARLY
Ulnar nerve damage is not uncommon. Mild symptoms recover spontaneously; even a complete palsy will usually recover but, if there is the possibility that the nerve is kinked in the joint, exploration should be considered.
LATE
Stiffness of the elbow is common and extension often limited for months; but, provided movement is not forced, it will eventually return.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
disregarded不顾，不理会，无视
retrieve /rɪˈtriːvn. [计] 检索；恢复，取回vt. [计] 检索；恢复；重新得到vi. 找回猎物
complex /kəmˈpleks,ˈkɑːmpleks/n. 复合体；综合设施adj. 复杂的；合成的
kink /kɪŋk/n. 扭结；奇想；蜷缩n. (Kink)人名；(瑞典)欣克vt. 使扭结vi. 扭结
provided /prəˈvaɪdɪd/conj. 假如，倘若v. 提供，给予（provide 的过去式和过去分词
百度翻译：
治疗
轻微位移可不予考虑。这是关节外骨折，所以只要孩子愿意肘部就可以被调动。如果上髁困在关节中，必须将其释放。
手法与肘部外翻和手腕过度伸展(拉屈肌)可能成功;如果失败，必须打开关节(必须观察和保护尺神经)，取出碎片并将其固定回原位。
不困于关节内的移位骨折通常不需要手术:但是，如果存在外翻不稳定(因为内侧副韧带复合体附着在骨块上)，则建议复位和钉扎。
并发症
早期
尺神经损伤并不少见。轻度症状自行恢复;即使是完全的瘫痪通常也会恢复，但是，如果有神经在关节处扭曲的可能性，就应该考虑进行探查。
晚期
肘关节僵硬是常见的，伸直时间往往长达数月;但是，只要不是被迫迁移，它最终还是会回来的。