儿童GartlandⅢ型肱骨髁上骨折治疗后并发症分析  

Analysis of complications of Gartland Ⅲ type supracondylar fracture of humerus after treatment in children

作　　者：王志京[1] 李立鹏[1] 张连起[1] 

机构地区：[1]北京市潮白河骨伤科医院骨科,北京101300

出　　处：《临床骨科杂志》2013年第4期415-417,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨儿童GartlandⅢ型肱骨髁上骨折并发症的防治。方法回顾分析176例GartlandⅢ型肱骨髁上骨折患儿治疗后的并发症情况及肘关节功能恢复情况。结果骨折复位后,22例出现骨筋膜室综合征早期症状,去除石膏后症状均缓解或消失。石膏固定中,74例骨折不稳定,至少进行了2次复位。克氏针固定中,无医源性血管神经损伤。患儿均获随访,时间1～18个月。发生肘内翻畸形17例,骨化性肌炎7例。肘关节功能评定:优135例,良30例,差11例。结论骨折早期应积极处理和预防血管、神经损伤及骨筋膜室综合征,肘内翻畸形和骨化性肌炎的防治应贯穿于复位、固定及功能康复的全过程。尽早行骨折闭合复位经皮克氏针固定治疗可减少并发症的发生。Objective To investigate measures for prevention and management of complications of Gartland llI type su- pracondylar fracture of humerus in children. Methods 176 cases of supracondylar fracture of Gartland m type hume- rus were treated, whose complications and the function of elbow were retrospectively analyzed. Results After reduc- tion, 22 cases had pre-symptom of osteofascial compartment syndrome that disappeared by throwing away piaster fixas- ion. 74 cases with piaster fixasion were undergone twice reduction at least because of removing of bone. There were not vascular and neural injuries in operation of K-wire internal fixation. The duration of follow-up was 1 - 18 months. Cubitus varus deformity was found in 17 cases and myositis ossificans in 7 cases. According to standard of the function of elbow, the results were excellent in 135 cases, good in 30, and poor in 11. Conclusions It is important to prevent vascular and neural injuries in early stage. Satisfactory reduction, good fixation and function rehabilitation are important for preventing Cubitus varus deformity and myositis ossificans. Closed reduction plus percutaneous K-wire fixation as soon as possible is a good method to reduce complicasions.

关 键 词：肱骨髁上骨折 儿童 闭合复位 经皮克氏针固定 并发症 

分 类 号：R683.41[医药卫生—骨科学] R687.3[医药卫生—外科学]