经皮撬拨复位双克氏针内固定联合石膏托治疗儿童GartlandⅢ型肱骨髁上骨折  

Closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children

作　　者：姚真[1] 林志金[2] 曹烈虎[2] 张春才[2] 王攀峰[2] 刘欣伟[2] 苏佳灿[2] 

机构地区：[1]新昌县人民医院手外科,浙江绍兴312500 [2]第二军医大学长海医院骨科,上海200433

出　　处：《中国骨伤》2011年第4期336-338,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:观察经皮撬拨复位双克氏针内固定联合石膏托治疗儿童GartlandⅢ型肱骨髁上骨折的临床疗效。方法:自2007年6月至2008年12月,采用经皮撬拨复位双克氏针内固定联合石膏托治疗儿童GartlandⅢ型肱骨髁上骨折27例。男18例,女9例;年龄6～12岁,平均8.1岁。伸直型15例,屈曲型12例;尺偏型14例,桡偏型13例。伤后就诊时间0.5～8d,平均3.6d。结果:27例均获随访,时间6～24个月,平均13.5个月。所有骨折均于术后4～6周愈合,平均愈合时间4.5周。未出现内固定物松动和骨折再移位,无Volkmarm挛缩、针眼或深部感染、尺神经损伤、骨化性肌炎等并发症。术后发生肘内翻畸形2例,但内翻角均不超过15°,可能为过早拆除外固定和不适当功能锻炼所致。按Flynn标准评定,结果优19例,良5例,可2例,差1例。结论:C形臂X线机透视下闭合复位经皮克氏针内固定治疗儿童不稳定肱骨髁上骨折手术创伤小,固定可靠,可以获得良好的肘关节功能和外形。Objective：To investigate the therapeutic effects of closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children.Methods：From June 2007 to December 2008,27 patients with GartlandⅢsupracondylar fractures were treated with closed reduction and percutaneous Kirschner wire fixation combined with plaster support.Among the patients,18 patients were male and 9 patients were female,ranging in age from 6 to 12 years,with an average of 8.1 years.Fifteen patients were extension type,12 patients were buckling type;fourteen patients were ulnar deviation,13 patients were radial deviation.The duration from injury to treatment ranged from 0.5 to 8 days,averaged 3.6 days.Results：Twenty-seven patients were followed up,and the duration ranged from 6 to 24 months,averaged 13.5 months.The healing time ranged from 4 to 6 weeks after surgery,with a mean of 4.5 weeks.Complications including implants loosening,fracture re-displacement,Volkmarm contraction,needle point or deep infection,ulnar nerve injury,myositis ossificans were found during follow-up.Two patients had postoperative elbow varus,but the varus angle was not more than 15 degree,which may be due to inappropriate functional exercise or early removal of external fixation.According to Flynn criteria,19 patients got an excellent result,5 good,2 poor and 1 bad.Conclusion：Closed reduction and percutaneous Kirschner wire fixation combined plaster surpport for the treatment of unstable supracondylar fractures in children has advantages including little trauma,reliable fixation,good elbow function and appearance.

关 键 词：肱骨骨折 骨折固定术 内 儿童(6-12) 肘关节 

分 类 号：R683.41[医药卫生—骨科学]