改良手术入路转移植骨内固定治疗儿童肱骨髁上骨折  

Open Reduction and Internal Fixation With the Grafted Sclerite via Improved Surgical Approach for Supracondylar Fractures in Children

作　　者：崔彩清[1,2] 李长彬 邓雪峰[1,2] 赵振普[4] 梁国伟[1,2] 

机构地区：[1]深圳龙华新区观澜医院 [2]广东医学院附属观澜医院骨科,深圳518110 [3]兰州军区空军机关医院放射科,兰州730020 [4]兰州军区总医院安宁分院,兰州730070

出　　处：《中国现代手术学杂志》2013年第1期30-32,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的观察改良手术入路转移植骨内固定治疗儿童肱骨髁上骨折的临床疗效及预防肘内翻的作用。方法 2005年1月～2010年12月,采用肘后"S"形正中纵切口改良手术入路,取自肱骨髁上骨折桡侧近断端薄层骨片或骨碎片植于同骨折部尺侧处,克氏针交叉内固定,治疗儿童肱骨髁上骨折GartlandⅢ型15例。结果 15例均获随访,平均时间30(12～48)个月;术后肘关节功能按Flynn等临床功能评定标准:优14例,良1例。无肘内外翻畸形。结论该术式暴露充分,不增加受伤组织的"再损伤",直视下复位、固定、植骨;操作简单,手术风险小,功能恢复好;在预防肘内翻畸形方面,可取得比较满意的临床效果。Objective To evaluate the clinic effect and the effect of prevent cubitus varus deformity by open reduction and internal fixation with the grafted sclerite via improved surgical approach for the treatment of supracondylar fractures in children.Method From January 2005 to December 2010,a total of 15 children with supracondylar fractures,typing Gartland Ⅲ were treated by open reduction,bone graft with a thin layer of bone fragments from the port of fracture on radical side or sclerite transplanted to the same position of fracture,and Kirschner wire internal fixation via the improved approach of postcubital ＇ s ＇-shape longitudinal median incision.Results All the 15 patients were followed up from 12 to 48 months with an average of 30 months.According to the clinical standard of Flynn evaluating function,the outcome revealed excellent in 14 cases and good in one case.No cubitus varus deformity or evaginate deformity was found.Conclusion The operation is simple and safe for supracondylar fractures in children with many advantages as sufficient exposure,no recurrence of secondary injury,operating such as reduction,fixation and bone grafted under orthophoria,good functional rehabilitation and satisfactory effect of prevention of elbow dubitus varus.

关 键 词：肱骨骨折 骨折固定术 内 骨移植 肘内翻 儿童 

分 类 号：R726.83[医药卫生—儿科] R683.41[医药卫生—临床医学]