尺神经沟置针术式治疗儿童Gartland Ⅲ型肱骨髁上骨折  

Internal fixation with cross Kirschner wires in sulcus for ulnar nerve and epicondylus lateralis of humerus in treatment of Gartland Ⅲ supracondylar fracture of humerus in children

作　　者：朱亚中 周嵘 徐云钦 陈冰 刘志安[2] 王春生[3] 

机构地区：[1]解放军第九八医院全军创伤骨科修复重建中心,浙江湖州313000 [2]江苏徐州医学院解剖系,江苏徐州221000 [3]湖州师范学院卫生统计学教研室,浙江湖州313000

出　　处：《中国骨与关节外科》2013年第6期510-514,共5页Chinese Journal of Bone and Joint Surgery

基　　金：军区医学科学技术研究"十一五"计划课题(06MA11)

摘　　要：背景：交叉克氏针内固定是目前治疗儿童GartlandⅢ型肱骨髁上骨折的首选方法，但仍未从根本上解决并发症发生问题。目的：评价尺神经沟置针术式治疗儿童GartlandⅢ型肱骨髁上骨折的可行性及疗效。 方法：1998年1月到2010年10月采用尺神经沟置针术式治疗儿童GartlandⅢ型肱骨髁上骨折患儿144例，随访时检查环小指运动及感觉情况，测量双上肢长度、肘关节活动度，摄双肘正位片测量Baumann角或提携角。采用HSS肘关节功能评价法评分标准进行肘关节功能评定。 结果：144例患儿，随访14~85个月，平均60个月，根据HSS肘关节功能评定法行功能评价：优140例，良4例，无肘内翻和肘外翻畸形发生，无继发尺神经损伤，肢体无短缩。 结论：尺神经沟置针术式治疗儿童GartlandⅢ型肱骨髁上骨折可获得良好的肘关节功能及外观，预防了肘内翻畸形及继发尺神经损伤，且对骨骺生长发育无明显影响。Background：Internal fixation with closed Kirschner wires is the preferred treatment for GartlandⅢsupracondylar fracture of humerus in children in recent years. But complications still occurred after the surgery. 〈br〉 Objective：To investigate the feasibility and curative effect of internal fixation with closed Kirschner wires in sulcus forulnar nerve and epicondylus lateralis of humerus in the treatment of GartlandⅢsupracondylar fracture of humerus in children. 〈br〉 Methods： A total of 144 children with Gartland Ⅲ supracondylar fracture of humerus were treated with internal fixation with cross Kirschner wires in the sulcus for ulnar nerve and epicondylus lateralis of humerus between January 1998 and Oc-tober 2010. The length of upper extremities, elbow joint range of motion, Baumann angle and carrying angle were mea-sured. The function of elbow joint was estimated by HSS scoring. 〈br〉 Results：The follow-up period ranged from 14 to 85 months （mean：60 months） in all the 144 patients. According to HSS score for elbow joint, excellent outcome achieved in 140 children and good results in 4 ones. No cubitus varus, cubitus val-gus, secondary injury of ulnar nerve or extremity shortness were observed. 〈br〉 Conclusions：Satisfactory appearance and elbow joint function can be obtained after internal fixation with Kirschner wires in the sulcus forulnar nerve and epicondylus lateralis of humerus for the treatment of GartlandⅢsupracondylar fracture of humerus in children. The treatment will not interfere with epiphyseal growth and can prevent from cubitus varus and second-ary ulnar nerve injury.

关 键 词：尺神经沟 尺神经 克氏针 髁上骨折 肘内翻 尺神经伤 儿童 

分 类 号：R726.8[医药卫生—儿科]