摘要
目的探讨可吸收棒内固定治疗儿童肱骨髁上骨折的手术方法及疗效。方法采用直径为1．5mm或2mm的超高分子聚-DL-乳酸（PDLLA）可吸收棒治疗儿童肱骨髁上骨折35例。经肘后正中“s”形切口，游离并保护好尺神经，肱三头肌舌形切开，显露骨折端。切开复位后2～3枚可吸收棒交叉固定，术中C臂x线机透视，并检查稳定性是否良好，术后行长臂石膏托外固定3周，3周后拆石膏进行肘关节屈伸功能锻炼，每1～2周复查x线片，观察骨折对位及愈合情况。结果本组35例得到全部随访，术后平均随访15个月（4～28个月），术后x线片示无骨折再移位，骨折全部愈合，无伤口感染，无骨化性肌炎及继发性尺神经损伤，发生肘内翻畸形1例；按Flynn肘关节评定标准，本组优27例、良6例、可2例，优良率为94．3％。结论PDLLA可吸收棒内固定治疗儿童肱骨髁上骨折，固定牢靠，效果理想，不影响骨骺发育，避免了再次手术取内固定。
Objective To discuss the surgical approach and clinical therapeutic effect of absorbable sticks in treating pediatric humeral supracondylar fracture. Methods 35 cases of pediatric humeral supracondylar fracture were treated with the ultra high molecular weight poly-DL-lactic acid （PDLLA） absorbable sticks which were about 1 .Smm or 2mm in diameter. The patients were treated with ＂S＂ shape incision at the elbow after median, free and protection of the ulnar nerve, triceps incision in tongue-shape and exposure in the broken ends of the fracture. The fracture was cross-fixed with 2-3 absorbable sticks. The stability was checked by C-arm fluoroscopy. The elbow was undergone by a long arm plaster external fixation for 3 weeks. The plaster was removed to do the flexion-extension function exercise after 3 weeks. Radi- ographs were reviewed every 1-2 weeks to observe the bone growth. Results All the 35 patients were followed up suc- cessfully for 4-28 months, average 15 months. Postoperative radiographs showed all fractures healed and no fracture shift. All patients had no wound infection, no myositis ossificans and no secondary ulnar nerve injury. 1 case of patients occurred cubitus varus deformity. According to Flynn elbow evaluation standard, 27 cases were excellent, 6 cases were good, 2 cases were general, and the excellent and good rate was 95%. Conclusion PDLLA absorbable sticks fixation for the treatment of pediatric humeral supracondylar fracture, have the advantages of reliable fixation, ideal effect, and no harmful effect on the epiphyseal growth. In order to avoid the secondary operation to take out the inner fixation, the familv members ofnatients are willine to accent and feel satisfaction.
出处
《生物骨科材料与临床研究》
CAS
2013年第3期43-45,共3页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
肱骨髁上骨折
内固定
可吸收棒
Supracondylar fracture of the humerus
Intemal fixation
Absorbable stick
