Gartland Ⅱ型肱骨髁上骨折切开与闭合复位内固定治疗疗效比较  

Open versus closed surgical treatment of Gartland type Ⅱ supracondylar fracture

作　　者：罗雷茗[1] 刘立航[1] 鲁晓波[1] 王远辉[1] 叶里子[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000

出　　处：《吉林医学》2013年第6期1003-1004,共2页Jilin Medical Journal

摘　　要：目的:比较内侧入路切开复位与闭合复位克氏针内固定治疗GartlandⅡ型肱骨髁上骨折的疗效差异。方法:选择典型GartlandⅡ型肱骨髁上骨折患儿24例。术前查体不伴有血管神经损伤。15例行闭合复位经皮克氏针内固定,9例行内侧小切口切开复位克氏针内固定治疗。结果:术后随访9～21个月,平均12个月。骨折全部愈合,肱骨远端形态恢复。其中闭合复位组2例,切开组1例出现关节活动受限,但屈伸功能受限<10°;闭合复位组1例出现迟发型尺神经麻痹,术后3.5个月逐渐恢复。两组的肘功能屈伸活动度和提携角差异无统计学意义(P>0.05)。结论:GartlandⅡ型肱骨髁上骨折闭合复位和内侧小切口切开复位克氏针内固定治疗疗效差异无统计学意义(P>0.05),建议先行闭合复位,两次复位不成功者则改用切开复位。Objective To compare the effect of open fracture of the medial approach were reset and closed reduction Kersh pin internal fixation for the treatment of type Gartland supracondylar humeruS.Methods Choose the typical type Gartland supracondylar fracture of humerus in 24 children.Preoperative examination without vascular nerve injury. 15 cases of closed reduction by matriarchal pike pin fixation in 9 cases,the medial incision treated with open reduction and internal fixation Kersh needle.Results Followed up for 9 -21 months after operation,an average of 12 months.All fractures healed,restore the morphology of distal end of humerus.The close reduction group 2 cases,1 cases had incision group limited joint mobility, but the flexion restriction 〈 10° ;Closed reduction group 1 cases delayed ulnar nerve palsy, gradually recovered 3.5 months after operation.The two group of the fimction of elbow flexion and extension and carrying angle had no significant difference（P 〉 0.05）. Conclusion Open reduction and internal fixation between Kersh needle therapy had no statistical significance of closed reduction and medial incision supracondylar fracture of Gartland 11 （P 〉 0.05）,suggest first closed reduction,two reset unsuccessful learners use open reduction.

关 键 词：肱骨髁上骨折 GARTLAND Ⅱ型 儿童 内固定 

分 类 号：R687.3[医药卫生—骨科学]