微创穿针治疗儿童肱骨髁上骨折62例临床分析  

The Clinical Effect of Close Reduction and Percutaneous Internal Fixation by Kwires for Supracondylar Humerus Fracture in Children

作　　者：王洪[1] 张亚峰[1] 张磊[1] 张波[1] 李益军[2] 

机构地区：[1]南通大学附属医院骨科,江苏226001 [2]启东市第二人民医院骨科

出　　处：《交通医学》2014年第3期228-230,共3页Medical Journal of Communications

摘　　要：目的：探讨微创穿针固定儿童肱骨髁上骨折的临床疗效。方法：儿童肱骨髁上骨折62例。按Gartland分型ⅡB型11例、ⅢA型29例、ⅢB型22例。所有患者均行闭合复位，经皮克氏针内固定术。术后定期随访，记录骨折愈合时间及并发症。结果：手术时间20～55分钟，平均31.6分钟，失血量5～30mL，平均14.1mL。62例均获得随访4～6月，平均5.3个月，均获得骨性愈合。医源性尺神经损伤2例，症状于术后2～4月消失。原发尺神经损伤3例，正中神经损伤5例，给予口服甲钴胺，被动功能锻炼，症状均于术后2～4月消失，未残留功能障碍。本组Flynn肘关节功能评定：优51例，良6例，优良率为91.94%。未出现肘关节内外翻畸形，无骨化性肌炎及Volkmann缺血性肌挛缩，神经功能恢复良好。结论：闭合复位微创穿针固定儿童肱骨髁上骨折手术时间短，失血量少，并发症少，疗效确切。Objective：To explore the clinical effect of close reduction and percutaneous internal fixation by K-wires for supracondylar humerus fracture in children. Methods： From January 2011 to August 2013, 62 patients were treated. According to Gartland Classification, 11 patients were Type IIB, 29 patients were Type IIIA, and 22 patients were Type II-IB. All the patients were treated with close reduction and percutaneous internal fixation by K-wires. All the patients were regularly followed up, and bone healing time and complications were recorded. Results： The average operation time was 31.6 minutes （20～55 minutes）, and the average blood loss was 14.1 mL （5～30mL）. All the patients were successfully fol-lowed-up. All the patients got successful bone healing. The average bone healing time was 5.3 months （4～6 months）. No skin necrosis, pin tract infection and myositis ossificans were seen. Two patients got iatrogenic ulnar nerve injury, and the symptoms disappeared 2 months after operation. No dysfunction was left. Conclusion：Close reduction and percutaneous in-ternal fixation by K-wires for supracondylar humerus fracture in children has many advantages, such as short operation time, small blood loss, and few complications, which constitutes a suitable method for the treatment of supracondylar humerus fracture in children.

关 键 词：肱骨髁上骨折 经皮穿针微创治疗 闭合复位 克氏针 儿童 

分 类 号：R683.41[医药卫生—骨科学]