经皮克氏针固定儿童不稳定性肱骨髁上骨折  

Percutaneous Kirschner wire fixation of unstable humeral supracondylar fractures in children

作　　者：吕云亮 杨蕊 杨超 LV Yun-liang;YANG Rui;YANG Chao(Zibo Municipal Hospital,Zibo255400,China)

机构地区：[1]淄博市市立医院,山东淄博255400

出　　处：《中国矫形外科杂志》2020年第20期1845-1848,共4页Orthopedic Journal of China

摘　　要：[目的]探讨闭合复位经皮克氏针内固定治疗儿童不稳定性肱骨髁上骨折的疗效。[方法]以2018年3月~2019年3月本院收治的76例不稳定性肱骨髁上骨折儿童为对象,采用随机数字表法分为两组,每组38例,经皮内固定组予以闭合复位经皮克氏针内固定,传统外固定组行闭合复位石膏外固定,对比两组疗效。[结果]两组患者均顺利施行骨折复位固定术。经皮固定组开始主动活动时间和完全负重活动时间均显著早于传统外固定组(P<0.05)。随治疗后时间推移,两组患儿肘关节ROM和Mayo评分均显著增加。治疗后8周时经皮内固定组的ROM和Mayo评分显著高于传统外固定组(P<0.05)。至末次随访时,经皮内固定组总并发症2例(5.26%);传统外固定组为8例(21.05%),差异有统计学意义(P<0.05)。影像方面,治疗后经皮内固定组Baumarm角显示小于传统外固定组,而携带角显著大于传统外固定组(P<0.05)。[结论]经皮克氏针内固定治疗儿童不稳定性肱骨髁上骨折的效果显著优于传统外固定。[Objective]To evaluate the clinical outcomes of closed reduction and percutaneous Kirschner wire internal fixation for unstable humeral supracondylar fractures in children.[Methods]A total of 76 children who suffered from unstable supracondylar humerus fractures and were admitted into our hospital from March 2018 to March 2019 were enrolled in this prospective study.According to random number produced by computer,the children were divided into two groups.Of them,38 patients had fractures fixed by percutaneous Kirschner wire secondary to closed reduction(the PKW group),while the other 38 patients received conventional closed reduction and external fixation with plaster splint(the EF group).The clinical consequences were compared between the two groups.[Results]All the children in both groups had fractures reduced and fixed smoothly.The PKW group returned to active motion and full weight-bearing activity significantly earlier than the EF group(P<0.05).As time went after treatment,the elbow extension-flexion ROM and Mayo score significantly increased in both groups(P<0.05).The PKW group proved significantly superior to the EF group regarding ROM and Mayo score at 8 weeks after treatment(P<0.05).To the latest follow up,the total complications were of 2 cases(5.26%)in the PKW group,whereas 8 cases(21.05%)in the EF group,which was statistically significant(P<0.05).With respect of radiographic assessment,the PKW group had significantly less Baumarm's angle,while greater carrying angle than that in the EF group(P<0.05).[Conclusion]This percutaneous Kirschner wire fixation is considerably superior to the conventional closed reduction and external fixation for unstable humeral supracondylar fractures in children.

关 键 词：不稳定性肱骨髁上骨折 闭合复位 经皮克氏针固定 儿童 

分 类 号：R683.41[医药卫生—骨科学]