闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折的研究  

The study of percutaneous kirschner wires fixation after closed reduction in treating supracondylar fractures of the humerus in children

作　　者：许益文[1] 郑勇[1] 白祥军[1] 刘俊[1] 李彦武[1] 石振[1] 游景扬[1] 范江荣[1] 张柘[1] 

机构地区：[1]华中科技大学同济咸宁医院骨科,湖北咸宁437000

出　　处：《生物骨科材料与临床研究》2015年第4期37-39,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的 探讨影响闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折临床疗效因素.方法 回顾性分析我院2010年7月～2012年12月52例采用闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折的临床资料,其中男35例,女17例,年龄2.5～12岁,平均6.7岁,11例Garland Ⅱ型,41例GarlandⅢ型,51例伸直型,1例屈曲型;分析在临床治疗过程中影响该方法疗效的相关因素.结果 本组52例均得到随访12～18个月,按照肘关节功能评价Flynn标准进行评价,其中优41例,良8例,可3例,差0例.优良率94.2％.结论 微创治疗儿童肱骨髁上骨折具有创伤小、恢复快、骨折固定稳定、预防骨筋膜室综合征及Volkmann挛缩、防止肘内翻、肘关节功能好等优点;但术中术后相关因素影响预后,如反复复位、复位不佳、未注意对神经血管的保护、手法不当、尺神经的损伤、克氏针的方向不当、外固定时间过短、锻炼不及时等.Objective To analyze many factors about the effect of closed reduction and percutaneous kirschner wires fixation in treating supracondylar fractures of the humerus in children. Methods There were fifty-two cases of humeral supracondylar fracture through our retrospectively analysis which treated by closed reduction and percutaneous kirschner wires fixation from July 2010 to December 2012. They were 2.5 to 12 years old （mean age： 6 years to 7 months, 35 males and 17 females）. According to Garland typing, type- Ⅱ are 11 cases, and type-Ⅲ 41 cases. 51 cases had extension type, one flex. Many factors we must take about affect the management of these cases treated by this method. Results Fifty-two cases were all followed up for 12 to 18 months. According to Flynn criteria of Elbow Functional assessment, 41 cases had excellent results, 8 cases good, 3 cases fair and no one bad. The excellent-good rate of elbow functions in the group was 94.2%. Conclusion Minimally invasive for humeral supracondylar fracture in children possess many ad- vantages such as： smallinjury, recovering quickly, stable bone fixation, preventing osteofascial compartment syndrome and Volkmann contracture, preventing cubitus varus, having excellent elbow joint function. There were also many factors which affected the prognosis with the method, including repeatedly brutal reduction, bad reduction of fracture, didn＇t pay attention to protect nerve and blood vessel in closed reduction, improper closed reduction, injury of ulnar nerve by kirschner wires, improper orientation of kirschner wires, no enough time of external fixation post-operation, functional training not in time, and so on.

关 键 词：微创 闭合复位 经皮克氏针固定 儿童 肱骨髁上骨折 

分 类 号：R726.8[医药卫生—儿科]