闭合复位经皮穿针治疗儿童肱骨髁上骨折的疗效  

Effects of closed reduction and percutaneous Kirschner wire osteosynthesis on humerus epicondyles fracture in children

作　　者：马杰德[1] 张治堂 张新栋[1] 

机构地区：[1]甘肃省白银市第二人民医院骨科,甘肃白银730900

出　　处：《海南医学院学报》2009年第12期1583-1585,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020090280)~~

摘　　要：目的:讨论闭合复位经皮克氏针治疗儿童肱骨髁上骨折(Gartland3型)的方法及疗效的评估。方法:自2001～2007年用闭合复位经皮克氏针治疗儿童肱骨髁上骨折(Gartland3型)56例。平均年龄8岁,受伤至手术时间平均7h。氯氨酮或臂丛麻醉,俯卧位,患肢外展置于自制支架,肘窝正好位于支架边缘,前臂与床面垂直,变换角度牵引复位,从肱骨内、外上髁远端钻入克氏针至对侧骨皮质或肱骨髓腔。石膏托屈肘60～70度、前臂中立位固定。结果:术后随访50例,6例失访。随访时间6～24月,平均随访13月。优46例,良3例,中1例。轻度尺偏3例,无Volkmann缺血挛缩,骨化性肌炎1例、针道感染2例,无骨折不愈合。结论:闭合复位经皮穿针是治疗儿童肱骨髁上骨折(Gartland3型)微创、有效的方法,急诊手术效果更佳。Objective：To evaluate the efficacy of closed reduction and percutaneous Kirschner wire osteosynthesis on humerus epicondyles fracture （Gartland ⅡI type） in children. Method： From 2001 to 2007,56 humerus epicondyles fracture cases with an average of 8 years were treated with closed reduction and percutaneous Kirschner wire osteosynthesis within 7 hours after injury. After brachial plexus anesthesia being induced by ketamine,the patients lied on the operation table in prone position with the injured arm stretching out, the cubital fossa placing on the edge of a self-made shelf, and the forearm being vertical to the table, then kirschner wire was pricked from medial and lateral epicondyle to the bone cortex or pulp cavity on the other side. Require patients to bend elbow at 60-70 degree, then fix the forearm in neutral position with a plaster slab. ReSUltS： According to an average of 13-month follow up （ ranged from 6 months to 24 months） which were carried out on 50 cases, excellent outcomes were presented in 46 case, good outcomes in 3 cases and normal outcome in 1 case. Slight ulnar deviation occurred in 3 cases, myositis ossificans in 1 case, and needle track infection in 2 cases. No Volkmann＇s contracture or nonunion cases was found. Conclusion： Closed reduction and percutaneous Kirschner wire osteosynthesis is an effective and minimal invasive treatment for humerus epicondyles fracture in children, especially in acute stage.

关 键 词：肱骨髁上骨折 闭合复位 经皮穿针 儿童 

分 类 号：R683.41[医药卫生—骨科学]