不同类型儿童肱骨髁上骨折的治疗探讨  

Therapies for Different Types of Supracondylar Fractures of the Humerus in Children

作　　者：郭学德[1] 梁西俊[1] 

机构地区：[1]亳州市人民医院骨科,亳州236800

出　　处：《中国微创外科杂志》2011年第3期253-255,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨不同类型儿童肱骨髁上骨折的治疗方法。方法对GartlandⅠ型骨折,单纯应用石膏外固定;GartlandⅡ型和Ⅲ型骨折,选择闭合复位、经皮穿针内固定;对于闭合复位、经皮穿针失败或伴有明显血管、神经损伤症状以及患肢肿胀特别严重的病例,采用切开复位克氏针内固定。结果未出现骨筋膜室综合征、血管或神经受损等并发症。术前合并神经损伤的病例,其神经功能得以完全恢复。56例随访16~28个月,平均20.6月,按F lynn功能评价标准,优38例,良16例,可1例,差1例。结论针对不同类型儿童肱骨髁上骨折采取相应的治疗方法,疗效满意。Objective To explore the appropriate treatments for different types of supracondylar fractures of the humerus in children. Methods Totally 56 cases of supracondylar fractures of the humerus were enrolled into this study.External fixation with plaster cast was used for Gartland type Ⅰ fracture,and closed reduction combined with percutaneous internal fixation was employed for patients with Gartland type Ⅱ or ⅢI fracture.In the cases of failure in closed reduction and percutaneous internal fixation,severe injuries to the vessels or nerves,or severe swelling of injured limbs,open reduction combined with internal fixation with Kel＇s needle was performed. Results In our patients,neither osteofascial compartment syndrome nor injuries to the vessels or nerves occurred.In the cases of pre-operative neural injury,the function of the injured nerve recovered completely after the treatment.The patients were followed up for 16 to 28 months with a mean of 20.6 months,during which,based on Flynn scoring system,38 patients achieved excellent results,16 were good,1 was improved,and the other was poor. Conclusions Therapeutic regime for supracondylar fractures of the humerus shall be determined by the type of the fracture.

关 键 词：肱骨髁上骨折 内固定 外固定 儿童 

分 类 号：R726.8[医药卫生—儿科]