肘前入路治疗Garland Ⅲ型肱骨髁上骨折的疗效观察  

Treatment of Gartland type Ⅲ supracondylar humeral fracture in children through an anterior approach

作　　者：张刚[1] 刘丹丹[1] 孙劲松[1] 田俊严[1] 邢齐宁[1] 董蒨[2] 

机构地区：[1]济宁医学院附属医院小儿外科,山东省济宁市272029 [2]青岛大学附属医院小儿外科,山东省青岛市266003

出　　处：《临床小儿外科杂志》2016年第6期575-578,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的介绍肘前入路复位并交叉克氏针固定治疗儿童GartlandⅢ型肱骨髁上骨折的手术方法与临床疗效。方法2007年4月至2015年4月我们收治GartlandⅢ型骨折患儿120例，均采用肘前L形小切口复位，运用肱骨内外髁交叉克氏针固定，术后3-4周拆除固定并行个体化功能锻炼，术后24周根据Flynn肘关节临床功能评定标准对患儿进行功能及外观评价。结果120例患儿手术后均获得满意复位与固定，无尺神经损伤，随访24～36周，平均23周。出现肘内翻2例，发生率1．67％，24周疗效评价优良率93．3％。结论肘前入路并交叉克氏针固定可实现骨折的安全快速解剖复位与固定，无严重并发症，能兼顾功能与外观，是部分儿童GartlandⅢ型肱骨髁上骨折的有效治疗方法。Objective To explore the treatment of Gartland typeⅢ supracondylar humeral fracture in children through an anterior approach and fixation with biplanar crossed Kirschner wire. Methods Open re- duction via an anterior elbow ＂L＂ mini-incision was performed and fixed with biplanar crossed Kirschner wire. Then postoperative functional exercise was performed after 3 - 4 weeks. Functional outcomes were evaluated ac- cording to the Flynn＇ s criteria after 24 weeks. Results A total of 120 cases achieved excellent reduction and fixation without an injury of ulnar nerve. The average follow-up period was 23 （24 - 36） weeks. Two cases had cubitus varus with an incidence of 1.67% . And the excellent or good rate was 93.3% after 24 weeks. Conclusions Open reduction through an anterior approach and fixation with biplanar crossed Kir- sehner wires allows for safe and rapid reduction with full anatomic alignments, satisfactory functional and cos- metic outcomes and fewer complications. It is an effective remedy for Gartland type Ⅲ supracondylar humeral fracture in children.

关 键 词：肱骨髁上骨折 治疗 观察 

分 类 号：R726.8[医药卫生—儿科]