自制克氏针外固定支架治疗儿童肱骨髁上骨折  

Treatment of humeral supracondylar fracture in children with home-made Kirschner wire fixation

作　　者：郭强[1] 吕守正[1] 李志永[1] 商福青 张英剑[1] GUO Qiang;LV Shou-zheng;LI Zhi-yong;SHANG Fu-qing;ZHANG Ying-jian(Department of Orthopaedics, Baodi Clinical College Affiliated to Tianjin Medical University,Tianjin 301800, China;Baodi Clinical College Affiliated to Tianjin Medical University)

机构地区：[1]天津医科大学宝坻临床学院骨科

出　　处：《中国城乡企业卫生》2019年第7期37-40,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的探讨儿童CartlandⅠB、Ⅱ、Ⅲ型肱骨髁上骨折予以闭合复位和经皮穿针并自制克氏针外固定支架治疗的手术方式和疗效。方法选取2008年8月-2018年2月天津医科大学宝坻临床学院收治的儿童GartlandⅠB、Ⅱ、Ⅲ型肱骨髁上骨折202例为研究对象。全部采取骨折闭合复位(或局部有限切开)和经皮穿针并自制克氏针外固定支架治疗,观察预后效果。结果 178例获得随访,随访时间3个月~2年,平均8个月。骨折于术后2~3个月后全部达到骨性愈合。针孔浅表感染2例,神经损伤7例,干预后均恢复正常。骨化性肌炎1例,肘关节伸直受限2例,轻度肘内翻畸形3例,干预后未完全恢复正常。疗效优145例,良30例,可3例,差0例,优良率为98.3%。结论闭合复位和经皮穿针固定并自制克氏针外固定支架治疗效果明显,值得临床推广应用。Objective To explore the operative methods and effects of closed reduction and percutaneous external fixation with home-made Kirschner wire in treating Gartland Ⅰ B,Ⅱ,Ⅲ humeral supracondylar fracture in children.Methods 202 children with Gartland type Ⅰ B,Ⅱ,Ⅲ humeral supracondylar fracture.admitted to Baodi Clinical College Affiliated to Tianjin Medical University from August 2008 to February2018 were selected as the study subjects.All the children were performed closed reduction(or locally finite incision)and percutaneous external fixation with home-made Kirschner wire.The prognostic effect was observed.Results 178 cases were followed up for 3 months to 2 years,with an average of 8 months.Bone healing was all achieved 2 to 3 months after operation.2 cases of superficial pinhole infection and 7 cases of nerve injury recovered after intervention.1 case had myositis ossificans, 2 cases had limited elbow extension and 3 cases had mild cubitus varus deformity, which did not completely return to normal after intervention.The curative effect was excellent in 145 cases, good in 30 cases,fair in 3 cases and no poor case.The excellent and good rate was 98.3%.Conclusion Closed reduction and percutaneous home-made Kirschner wire external fixation are effective and worthy of clinical application.

关 键 词：儿童肱骨髁上骨折 克氏针 外固定 

分 类 号：R683.41[医药卫生—骨科学]