闭合复位、经皮克氏针固定治疗儿童完全移位的肱骨髁上骨折  

Closed Reduction and Percutaneous Pinnning of Severely Displaced Supracondylar Fractures of the Humerus in Children

作　　者：杨建平[1] 刘宝琨 张质彬[1] 戴祥麒[1] 马志坚[1] 任秀智[1] 李建江[1] 李恩琪[1] 

机构地区：[1]天津医院小儿骨科,300211 [2]整复治疗中心

出　　处：《中华骨科杂志》1999年第11期659-661,共3页Chinese Journal of Orthopaedics

摘　　要：评价闭合复位、经皮克氏针固定治疗儿童完全移位的肱骨髁上骨折的，临床效果。方法　从１９９７年２月～１９９８年７月在“Ｃ”型臂Ｘ线机透视下，采用闭合复位、经皮克氏针固定治疗儿童完全移位的肱骨髁上骨折共４３例。患儿的平均年龄为６岁７个月（２～１３．８岁）。伸直尺偏型２７例，伸直桡偏型１４例，屈曲型２例。在臂丛麻醉和“Ｃ”型臂Ｘ线机透视下，先行闭合整复骨折，然后经皮穿入两枚交叉克氏针固定。结果　本组４２例获得随访，平均随访时间为１８个月（１１～２７个月）。患侧肘关节伸直平均为－８°；屈曲平均为１３０°。随访时无一例发生Ｖｏｌｋｍａｎｎ挛缩、肘内翻畸形。结论在骨折复位满意后，采用经皮交叉克氏针固定，能避免骨折远端向尺侧的再移位，消除了肘内翻形成的因素；不需极度屈肘外固定，因而能防止前臂Ｖｏｌｋｍａｎｎ挛缩的发生；住院时间短，肘关节功能恢复满意。Objective To retrospectively study the results of forty-three children treated for dis- placed supracondylar fractures of the humerus. Methods All of the fractures were Gartland type －Ⅲ and were treated by closed reduction and percutaneous crossed-pin fixation under image intensifier. The mean age of patients was 6. 6 years old (range, 2 - 13. 8 years) at the initial injury. The average follow-up was 18 months (range, 11 - 27 months). Results Forty-two patients were examined for function and deformity. There were no patient developed a cubitus varns, or Volkmann's contracture at follow-up evaluation. Conclusion Closed reduction with percutaneous pin fixation is preferred for the treatment of this fracture, which is stabilized by the internal fixation that can control reduction and prevent redisplacement of the distal fragments. The elbow can be splinted in a safe position, minimizing the risk of Volkmann's contracture. The function of the elbow is satisfactory.

关 键 词：儿童 肱骨髁上骨折 骨折固定术 闭合复位 

分 类 号：R726.834.1[医药卫生—儿科]