摘要
目的讨论儿童肱骨髁上骨折手术治疗指征、手术方法及入路的选择、影响手术疗效的因素和如何降低骨折并发症的发生。方法对2000年3月~2005年8月我院收治的儿童严重型（GartlandⅢ型）肱骨髁上骨折181例手术治疗的疗效进行评价,分析肱骨髁上骨折手法复位失败、开放性骨折、合并神经血管损伤及陈旧性骨折伴畸形影响肘关节功能等严重病例采用切开复位克氏针固定治疗结果。结果随访时间1~5年,平均3年。按肘关节功能评价Flynn标准进行评价,优142例,良21例,优良率90.05%,可13例,差5例。发生肘内翻25例（13.81%）。结论儿童严重型肱骨髁上骨折切开复位仍是主要治疗手段,准确复位骨折两断端和牢固内外固定、早期进行肘关节功能锻炼是提高治疗疗效、防止肘内翻畸形发生的重要措施。
Objective To discuss the operation indications, surgical approach, factors influencing the surgical effect and how to reducing postoperative complications for severely displaced supracondylar fracture of the humerus （Gartland type-Ⅲ ）. Methods Through evaluating the therapeutic effects of severely displaced supracondylar fracture of the humerus（Gartland type-Ⅲ ） with Kir- scher wire in our hospital from Mar. 2000 to Aug. 2005,181 eases were analyzed,including failure of reduction by hand,open fracture, fracture accompanied by vascular and nerval injuries as well old fracture affecting function of elbow joint. Results The average follow-up period was 3 years（range from 1 to 5 years） in 181 cases examined. To evaluate the function of elbow joint according to Flynn criterion, 163 cases were excellent and good with the rate of 90.5%. There were 13 ordinary cases and 5 poor cases,25 cases appeared cubitus varus deformity（13.81%）. Conclusion Severely displaced supraacondylar fracture of the humerus still needs open reduction. Accurate restoration, hard intermal and external fixation,early elbow joint functional training are the important measures for enhancing curative effect and reducing cubitus varus deformity.
出处
《重庆医学》
CAS
CSCD
2007年第9期793-794,796,共3页
Chongqing medicine
关键词
肱骨髁上骨折
手术治疗
肘内翻
supracondylar fracture of humerus
surgical treatment
cubitus varus
