摘要
目的探讨闭合复位克氏针内固定治疗GartlandⅡ、Ⅲ型儿童肱骨髁上骨折的疗效。方法对30例GartlandⅡ、Ⅲ型肱骨髁上骨折(伸直型)患儿采用闭合复位经皮克氏针交叉固定(内髁1枚,外髁2枚)治疗。术后石膏托外固定3～4周,4～6周去除克氏针,指导患儿功能锻炼。结果手术时间19～72 min,透视次数11～32次,住院时间2～6 d。患儿均获得随访,时间3～6个月。未出现因内固定松动而失败的病例。术后3个月采用Flynn肘关节功能评分标准评定疗效:优27例,良2例,可1例。术后未出现骨筋膜室综合征及Volkmann缺血性肌挛缩、肘内翻畸形。1例术前正中神经损伤,术后2个月逐渐恢复; 2例术前合并肱动脉损伤,术后血运均良好,其中1例出现Pink hand。结论急诊闭合复位3枚克氏针交叉内固定治疗GartlandⅡ、Ⅲ型儿童肱骨髁上骨折损伤小、固定牢固、愈合快、并发症少,患儿关节功能恢复良好。
Objective To investigate the effect of closed reduction and Kirschner wire internal fixation for Gartland type Ⅱ,Ⅲ supracondylar fracture of the humerus in childern. Methods Thirty cases of Gartland type Ⅱ,Ⅲ supracondylar fractures of humerus (straight type) were treated with closed reduction and percutaneous Kirschner wire internal fixation (1 internal hemorrhoid, 2 external hemorrhoids), and plaster slab external fixation was used for 3~4 weeks. After 4~6 weeks, the internal fixation Kirschner wire was removed to guide the primary and passive functional exercise of the children. Results The operation time was 19~72 min, the number of fluoroscopy was 11~32 times, and the hospital stay was 2~6 d.All children were followed up for 3~6 months. There were no cases of failure due to internal fixation loosening.Efficacy was assessed by using the Flynn elbow joint function score at postoperative 3 months: the excellent was in 27 cases, good in 2 cases,fair 1.There were no cases of compartment syndrome and Volkmann ischemic contracture and cubitus varus after surgery.One patient had a median nerve injury before operation and gradually recovered at 2 months after operation. Two patients with radial artery injuries had good blood supply after operation, and one patient had Pink hand. Conclusions Emergency closed reduction and three Kirschner wire cross internal fixation for the treatment of Gartland type Ⅱ,Ⅲ supracondylar fracture of the humerus in children, which is with less trauma, firm fixation, fast healing and fewer complications, and the children′s joint function recover well.
作者
王洪灵
柴林涛
王海洋
金晶
史金友
WANG Hong-lin;CHAI Lin-tao;WANG Hai-yang;JIN Jing;SHI Jin-you(Dept of Orthopaedics,the People′s Hospital of Guoyang County,Bozhou,Anhui 233600,China)
出处
《临床骨科杂志》
2019年第2期208-210,共3页
Journal of Clinical Orthopaedics
关键词
儿童
髁上骨折
闭合复位
微创
克氏针固定
child
supracondylar fractures
minimally invasive
closed reduction
Kirschner wire fixation
