摘要
目的观察三种不同闭合复位穿针方式治疗儿童Gartland Ⅲ型肱骨髁上骨折的临床效果。方法将2014年1月-2018年1月收治的Gartland Ⅲ型肱骨髁上骨折患儿45例随机分为三组,每组15例,分别为小切口辅助内外侧穿针组(A组)、内外侧交叉穿针组(B组)和单纯外侧穿针组(C组),观察手术情况、关节功能评分、有无并发症等。结果三组患儿骨折均骨性愈合。平均愈合时间8.5周。A组平均手术时间25.8 min,平均透视10.6次,关节功能优良率93.3%,钉道感染2例,无尺神经损伤;B组平均手术时间39.2 min,平均透视15.8次,关节功能优良率93.3%,钉道感染2例,尺神经损伤1例,拔除克氏针后好转;C组平均手术时间23.4 min,平均透视13.4次,关节功能优良率93.3%,钉道感染2例,无尺神经损伤。三组均无肘内翻。结论小切口辅助内外侧穿针方式能缩短手术时间,减少透视次数,是治疗Gartland Ⅲ型肱骨髁上骨折的一种有效方法。
Objective To observe the therapeutic effects of three different closed reduction and needle insertion methods in the treatment of Gartland type Ⅲ supracondylar fracture of the humerus. Methods Patients with Gartland type Ⅲ humeral supracondylar fractures admitted to our hospital from January 2014 to January 2018 were randomly divided into three groups: small incision assisted medial and lateral needle(group A) and medial and lateral needle(group B) and simple lateral needle(C group). The surgery condition, joint function, and complications were observated. Results All of the fractures healed,average time was 8.5 weeks, the average operation time of group A was 25.8 minutes, the average fluoroscopy was 10.6 times, the excellent rate of joint function was 93.3%, and the nail infection was in 2 cases without ulnar nerve injury. The average operation time of group B was 39.2 minutes, and the average fluoroscopy was 15.8 times. The excellent and good rate was 93.3%, 2 cases had nail infection, 1 case had ulnar nerve injury, and was improved after removal of Kirschner wire;the average operation time of group C was 23 minutes, the average fluoroscopy was 13 times, the excellent rate of joint function was 93.3%, and the infection of nail was in 2 cases, no ulnar nerve damage. None of the three groups had cubit varus. Conclusion Small incision assisted medial and lateral needle insertion can shorten the operation time and reduce the number of fluoroscopy. It is an effective method for the treatment of Gartland type Ⅲ supracondylar fracture of the humerus.
作者
底垚宗
DI Yaozong(Department of Joint Surgery, Beijing Pinggu Hospital, Beijing, 101200, China)
出处
《实用手外科杂志》
2019年第2期183-186,共4页
Journal of Practical Hand Surgery
关键词
肱骨髁上骨折
肘内翻
闭合复位
Supracondylar fracture of the humerus
Cubit varus
Close reduction
