切开复位克氏针与螺钉固定治疗小儿肱骨内上髁骨折比较研究  

Comparative analysis of open reduction Kirschner wire and screw fixation in the treatment of humeral medial epicondyle fractures in children

作　　者：康持 赵仁欢 陈伟[1] 邓志强[1] KANG Chi;ZHAO Ren-huan;CHEN Wei;DENG Zhi-qiang(Department of Pediatric Orthopedics,Sichuan Orthopedic Hospital,Chengdu 610001,China)

机构地区：[1]四川省骨科医院儿童骨科,四川成都610001

出　　处：《临床军医杂志》2021年第9期984-988,共5页Clinical Journal of Medical Officers

基　　金：四川省医学科研课题计划(s19065)。

摘　　要：目的对比分析切开复位克氏针与螺钉固定治疗小儿肱骨内上髁骨折的临床疗效。方法回顾性分析自2017年1月至2020年12月四川省骨科医院收治的78例肱骨内上髁骨折患儿的临床资料。根据治疗内固定方法将患儿分入克氏针组(克氏针张力带固定,n=32)和螺钉组(1枚螺钉+1枚克氏针固定,n=46)。观察并比较两组患儿末次随访时肘关节功能优良率、外观恢复优良率,以及手术时间、骨折愈合时间、内固定取出时间、肘关节功能恢复时间。结果克氏针组患儿末次随访肘关节功能优良率为93.75%(30/32),与螺钉组的91.30%(42/46)比较,差异无统计学意义(P>0.05)。克氏针组患儿末次随访时肘关节外观恢复优良率为90.63%(29/32),与螺钉组的89.13%(41/46)比较,差异无统计学意义(P>0.05)。两组患儿手术和骨折愈合时间比较,差异无统计学意义(P>0.05)。克氏针组患儿内固定取出时间短于螺钉组,肘关节功能恢复时间长于螺钉组,差异有统计学意义(P<0.05)。结论切开复位克氏针与螺钉固定在治疗肱骨内上髁骨折患儿中均可取得较好的临床效果,有效恢复肘关节功能与外观,但切开复位克氏针治疗后内固定取出时间更短,而螺钉固定治疗后肘关节功能恢复时间更快。Objective To comparatively investigate the effect of open reduction Kirschner wire or screw fixation in the treatment of humeral medial epicondyle fractures in children.Methods The clinical data of 78 children with internal humeral epicondyle fractures from January 2017 to December 2020 were retrospectively analyzed.According to the treatment method,the children were divided into the Kirschner wire group(kirschner wire tension band fixation,n=32)and the screw group(1 screw+1 Kirschner wire fixation,n=46).The excellent and good rate of elbow function,excellent and good rate of appearance recovery,operation time,fracture healing time,internal fixation removal time and elbow function recovery time were observed and compared between the two groups at the last follow-up.Results The excellent and good rate of elbow function in the kirschner wire group was 93.75%(30/32)at the last follow-up,and there was no statistical significance compared with 91.30%(42/46)in the screw group(P>0.05).At the last follow-up,the excellent and good rate of elbow appearance recovery in the Kirschner wire group was 90.63%(29/32),which was not statistically significant compared with 89.13%(41/46)in the screw group(P>0.05).There was no significant difference in surgery and fracture healing time between the two groups(P>0.05).The removal time of internal fixation in the Kirschner wire group was shorter than that in the screw group,and the recovery time of elbow joint function was longer than that in the screw group,with statistical significance(P<0.05).Conclusion Open reduction Kirschner wire and screw fixation can achieve good clinical results in the treatment of children with internal humeral epicondyle fractures,and both can effectively restore the function and appearance of the elbow joint.However,the internal fixation removal time after the open reduction Kirschner wire treatment is shorter,the recovery time of elbow joint function after screw fixation treatment is faster.

关 键 词：切开复位克氏针固定 切开复位螺钉固定 肱骨内上髁骨折 小儿骨折 临床疗效 

分 类 号：R683.41[医药卫生—骨科学]