急诊闭合复位经皮克氏针内固定治疗Gartland Ⅱ-Ⅲ型儿童肱骨髁上骨折  

Emergency closed reduction and percutaneous Kirschner wire fixation for treatment of Gartland type Ⅱ-Ⅲ supracondylar fractures of the humerus in children

作　　者：范江荣[1] 许益文[1] 郑勇[1] 游景扬[1] 

机构地区：[1]华中科技大学同济咸宁医院骨科,湖北咸宁437100

出　　处：《中国骨伤》2015年第5期464-467,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：探讨急诊闭合复位经皮克氏针内固定治疗GartlandⅡ-Ⅲ型儿童肱骨髁上骨折的临床疗效及相关危险因素分析。方法：回顾分析2008年1月至2013年6月急诊行闭合复位经皮克氏针交叉固定治疗112例GartlandⅡ-Ⅲ型儿童肱骨髁上骨折的临床资料。其中男72例,女40例;年龄2~11岁,平均6.2岁;GartlandⅡ型骨折74例,Ⅲ型38例;受伤至手术时间2.5~8 h,平均4.6 h。术后伸肘100°石膏固定4~6周后拆除石膏、拔除克氏针,行功能锻炼。结果：112例术后获得随访,时间6~60个月,平均12个月。所有骨折达到骨性愈合,术后末次随访按Flynn肘关节功能评价,优86例,良23例,一般3例,优良率97.3%。3例发生轻度肘内翻畸形,无须矫形处理。无针道感染、医源性尺神经损伤、骨筋膜室综合征及Volkmann缺血性挛缩等并发症发生。结论：闭合复位经皮克氏针固定具有维持复位确切、固定牢靠、并发症少、急诊手术患儿痛苦少、闭合复位成功率高等优点,是治疗移位型儿童肱骨髁上骨折安全、有效的方法。Objective：To analyze the clinical effect and related risk factors of Gartland type II-III supracondylar fractures of humerus in children in the emergency closed reduction and percutaneous Kirschner wire fixation. Methods：From January 2008 to June 2013,112 children of Gartland type II to III supracondylar humeral fractures were treated in children in emergency closed reduction and percutaneous K wire fixation,including 72 males and 40 females with an average age of 6.2 years old rang？ing from 2 to 11 years old. Among them,74 cases were in Gartland typeⅡfractures,38 cases were in typeⅢ;The duration from injury to surgery time was 2.5 to 8 hours（averaged 4.6 hours）. Elbow cast was applied after operation with the elbow extended of 100 degrees for 4 to 6 weeks,then the gypsum and Kirschner wires were removed. Results：All patients were follow-up from 6 to 60 months（averaged 12 months）. All fractures reached clinical healing. The final follow up was assessed by Flynn criteria,the result was excellent in 86 cases,good in 23 cases,general in 3 cases,excellent and good rate was 97.3%. Three patients had mild cubitus varus deformity without orthopedic treatment. No pin tract infections,iatrogenic ulnar nerve injury,compartment syn？drome,and complications such as Volkmann ischemic contracture occurred. Conclusion：Closed reduction and percutaneous Kirschner wire fixation had advantages of exact reduction,firm fixation,fewer complications,less pain in children undergoing emergency surgery,and high success rate,so it is a safe and efficient treatment for humeral supracondylar fracture in children.

关 键 词：肱骨骨折 儿童 骨折固定术 内 外科手术 

分 类 号：R683.41[医药卫生—骨科学]