小切口切开复位克氏针固定治疗儿童JacobⅢ型肱骨外髁骨折的临床疗效  

Mini-incision open reduction and K-wires fixation for Jacob typeⅢhumeral lateralcondylar fracture in children

作　　者：金瑞 林昱东 孙军[1] JIN Rui;LIN Yudong;SUN Jun(Department of Pediatric Orthopedics,Children’s Hospital of Anhui Medical University,Hefei 230051,China)

机构地区：[1]安徽医科大学附属安徽省儿童医院骨科,合肥230051

出　　处：《安徽医学》2021年第6期595-598,共4页Anhui Medical Journal

基　　金：国家自然科学基金联合基金项目(项目编号:U19A2057)。

摘　　要：目的探讨小切口切开复位克氏针固定治疗儿童JacobⅢ型肱骨外髁骨折中的临床疗效。方法回顾性分析2018年1月至2019年1月在安徽省儿童医院收治的JacobⅢ型肱骨外髁骨折患儿62例,男患儿34例,女患儿28例,右侧41例,左侧21例,均行小切口切开复位克氏针内固定。术后均予以屈肘90°旋后位石膏外固定,6周后复查摄片,根据骨痂生长情况,拆除石膏并拔出克氏针。末次随访时,评价手术治疗后的影像学变化及肘关节功能,并分析术后并发症发生的情况。结果62例患儿随访1~2年,平均(1.5±0.9)年,切口长度1.6~2.5 cm,平均(1.8±0.6)cm。末次拍片时骨折全部愈合,愈合时间5~9周,平均(6.5±2.6)周。Dhillon评估肘关节功能评分:优43例,良17例,可2例,差0例,优良率为96.77%。所有患儿均无严重肘内外翻畸形、迟发性尺神经炎、骨折延迟愈合及不愈合等并发症发生。结论小切口切开复位克氏针固定治疗儿童JckobⅢ型肱骨外髁骨折,切口小且临床疗效确切,无严重并发症发生。Objective To evaluate the clinical effect of mini-incision open reduction with K-wires fixation in the treatment of Jacob type III humeral lateralcondylar fracture in children.Methods A retrospective analysis was performed on 62 children with JacobⅢtype humeral lateral condyle fracture admitted to Anhui Provincial Children’s Hospital from January 2018 to January 2019,including 34 males,28 females,41 on the right side,and 21 on the left side.All of them received posterior lateral small incision open reduction and Kirschner wire internal fixation.After surgery,all the patients were casting in supinator with 90 degree flexion position of the elbow.After 6 weeks,the follow-up in a X-ray was reexamined.According to the growth of callus,the plaster was removed and K-wires was pulled out.At the last follow-up,the imaging characteristics and elbow joint function after operation were evaluated,and the incidence of postoperative complications was analyzed.Results The average follow-up time was(1.5±0.9)years,from 1 to 2 years.The average incision length was(1.8±0.6)cm,from 1.6~2.5 cm.The healing time was(6.5±2.6)weeks,from 5 to 9 weeks.According to Dhillon’s elbow function score,43 cases were excellent,17 cases were good,2 cases were fair,and 0 case was poor.The excellent and good rate was 96.77%.There was no severe cubitus varus deformity,delayed ulnar neuritis,delayed union or nonunion.Conclusions The mini-incision open reduction with K-wires fixation in the treatment of children with Jacob typeⅢhumeral lateralcondylar fracture has the advantages of mini-incision,excellent clinical outcomes and no serious complications.

关 键 词：肱骨外髁骨折 切开复位 小切口 克氏针 

分 类 号：R726.8[医药卫生—儿科]