儿童Gartland Ⅲ型肱骨髁上骨折不同入路ORPP治疗的比较研究  

Open reduction and percutaneous pinning for Gartland type Ⅲ supracondylar humeral fracture in children: medial-entry versus lateral entry

作　　者：朱诚 刘杰[1] 李少华[1] ZHU Cheng;LIU Jie;LI Shao hua(Dept. of Orthopedics, Tenth Peopled Hospital, Tongji University, Shanghai 200072, China;Dept.of Orthopedics, Ningbo Women & Children^ Hospital, Ningbo 315012, Zhejiang Province, China)

机构地区：[1]同济大学附属第十人民医院骨科,上海200072 [2]宁波市妇女儿童医院骨科,浙江宁波315012

出　　处：《同济大学学报（医学版）》2017年第5期79-83,共5页Journal of Tongji University(Medical Science)

摘　　要：目的探讨ORPP治疗儿童GartlandⅢ型肱骨髁上骨折的近期疗效及固定方式。方法 2013年1月至2014年12月,采取切开复位经皮克氏针内固定治疗GartlandⅢ型骨折108例,其中52例采取内侧入路(M ORPP组),56例采用外侧入路(LORPP组)。观察手术切口、手术时间、术中出血量,随访测量Baumann角、肱骨干髁角、肘关节活动度、提携角,并观察骨折愈合时间和并发症,收集数据并进行统计分析。结果 MORPP组的手术时间长于LORPP组,末次随访时MORPP组提携角丢失角度较少,所测Baumann角更小,差异均有统计学意义(均P<0.05)。术后两组并发症、肘关节功能差异无统计学意义(P>0.05)。结论恰当技术下M ORPP是一种治疗儿童GartlandⅢ型SCHF安全有效的手术方法;相比于LORPP,尽管手术的时间可能会延长,但手术并发症的发生率并没有升高,且复位更有效、内固定稳定性更高。ObjectiveTo compare the efficacy and fixation of medial entry and lateral entry open reduction percutaneous pinning(ORPP)for Gartland typeⅢsupracondylar humeral fracture in children.MethodsOne hundred and eight children with Gartland typeⅢsupracondylar humeral fracture were treated with the open reduction and percutaneous pinning(ORPP)from January2013to December2014,among whom52cases were treated with medial entry(MORPP group)and56with lateral entry(LORPP group).The surgical incision,operative time,intraoperative blood loss,the measured Baumann's angle,humeral condylar angle,elbow joint movement degree,carrying angle,fracture healing time and postoperative complications were documented and compared between two groups.ResultsThe MORPP group had a slightly longer operative time than the LORPP group,but the loss of carrying angle was less,the measured Baumann's angle is smaller(P<005).There was no significant difference in postoperative complications and elbow function between two groups(P>005).ConclusionMedial entry ORPP is a safe and effective surgical modality for Gartland typeⅢsupracondylar humeral fracture in children.Compared to lateral entry,the medial entry has a prolonged operation time,but the fracture reduction in medial entry was more effective,and the fixation was more stable without increased surgical complications.

关 键 词：肱骨髁上骨折 GartlandⅢ型 治疗 

分 类 号：R683[医药卫生—骨科学]