摘要
目的探讨儿童肱骨髁上骨折闭合复位后,其内侧采用经鹰嘴旁入路穿针内固定方法的临床疗效。方法对2015年9月-2018年6月收治的20例肱骨髁上骨折患儿均采用闭合复位结合交叉克氏针固定,其中肱骨内侧采用经鹰嘴旁的经皮克氏针内固定方式。评定其内固定治疗术后肘关节活动功能的效果。结果术后18例患儿获得了6~12个月随访,平均8.5个月,失访2例。所有随访病例肱骨髁上骨折全部愈合,骨折愈合时间为4.5~8.5周,均未发生Volkmann缺血性挛缩症现象,无尺神经麻痹,无骨化性肌炎及骨骺早闭;所有随访病例均未发生内固定克氏针松动、折断及肱骨髁内侧皮质劈裂、骨折移位。其中3例针眼处发生皮下渗液的浅表感染,经过伤口换药处理后得到控制。肘关节功能评定优13例(55.6%),良3(16.7%),可2例(11.1%),差0例(0%),优良率72.3%。结论对于儿童肱骨髁上骨折的治疗,在进行闭合复位后,其内侧采用经鹰嘴旁入路穿针内固定方法是安全、有效、容易的操作,固定更为可靠。因此采取闭合复位、经肱骨外髁穿针及结合内侧经鹰嘴旁入路穿针的交叉内固定治疗小儿肱骨髁上骨折方式值得临床推广应用。
Objective To investigate the clinical effect of internal fixation of supracondylar fracture of humerus in children after closed reduction.Methods From September 2015 to June 2018,All cases were fixed with closed reduction and cross Kirschner wire,and the medial humerus was fixed by percutaneous Kirschner wire near the eagle's beak to treat supracondylar fracture of humerus in children.Evaluated the functional indexes of elbow joint after internal fixation.Results Among the enrolled cases,18 children were followed up,and the remaining 2 were lost.The follow-up time ranged from 6 to 12 months,with an average follow-up of 8.5 months.All the supracondylar fractures of humerus healed in 4.5~8.5 weeks,and no Volkmann ischemic contracture,ulnar nerve paralysis,myositis ossificans and epiphysis premature closure occurred in all the follow-up cases.All the follow-up cases did not have loose or broken internal fixation Kirschner wire,split of medial cortex of humeral condyle and displacement of fracture.The superficial infection of subcutaneous exudation occurred in 3 cases of children,which was controlled after dressing change.According to the elbow joint function evaluation,the prognosis of all follow-up children was excellent in 13 cases(55.6%),good in 3 cases(16.7%),fair in 2 cases(11.1%),poor in 0 cases(0%),and the excellent and good rate was 72.3%.Conclusion For the treatment of supracondylar fracture of humerus in children,after closed reduction,it is safe,effective,easy to operate and more reliable to use the method of internal fixation through the parasauroral approach. Therefore, the treatment of supracondylar fracture of humerus in children by closed reduction, needle insertion through lateral condyle of humerus and cross internal fixation combined with needle insertion through medial approach near olecranon is worthy of clinical application.
作者
崔邦胜
陈棉智
郭锋
冯锡文
张志辉
CUI Bangsheng;CHEN Mianzhi;GUO Feng(Department of Orthopedics,Shunde Hospital of Guangzhou University of Chinese Medicine,Shunde,Guangdong,528300,China)
出处
《实用手外科杂志》
2021年第1期16-18,22,共4页
Journal of Practical Hand Surgery
基金
佛山市科技局科研项目(项目编号:2016AB003913)
黄枫广东省全国名中医传承工作室资助项目(项目编号:粤中医办函{2018}5号)。
关键词
肱骨髁上骨折
克氏针
经鹰嘴旁入路
Supracondylar fracture of humerus
Kirschner wire
Trans-olecranon approach
