单纯外侧克氏针固定治疗儿童肱骨髁上骨折稳定性及神经损伤情况分析  

Analysis of Stability and Nerve Injury of Humeral Supracondylar Fracture in Children Treated with Lateral Kirschner Wire Fixation Alone

作　　者：苏联彬 王承云 刘琦 王斯晟 陈永法 刘茂升 李楠竹[1] SU Lianbin;WANG Chengyun;LIU Qi;WANG Sisheng;CHEN Yongfa;LIU Maosheng;LI Nanzhu(Department of Pediatric Orthopedics,The First Affiliated Hospital of Xiamen University,Xiamen 361003,Fujian China)

机构地区：[1]厦门大学附属第一医院小儿骨科,福建厦门361003

出　　处：《中国中医骨伤科杂志》2022年第4期72-75,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：福建中医药大学校管临床专项课题(XB2021094)。

摘　　要：目的:探讨分析单纯外侧克氏针固定治疗儿童肱骨髁上骨折稳定性及神经损伤情况。方法:回顾2018年9月至2021年2月因肱骨髁上骨折收治本科手术治疗病例(共113例),记录分析患儿年龄,性别,侧别,骨折分型,患肢神经损伤情况,末次随访肘关节功能;比较术后1 d、术后2个月Baumann角。结果:共113例闭合复位成功,无切开病例,其中110例成功获得随访。术后发生桡神经损伤1例,无尺神经损伤,无肘内翻病例发生,术后第1天与术后2个月Baumann角对比(74.51°±4.12°vs 73.87°±3.62°),差异无统计学意义(P>0.05)。根据改良Flynn标准进行评定,所有病例术后6个月随访时均活动,优102例,良8例。结论:手法复位结合单纯外侧克氏针固定治疗儿童肱骨髁上骨折,操作简单,在避免医源性神经损伤的同时,能提供足够的稳定性,是一项可靠、安全的技术。Objective:To investigate the stability and nerve injury of children humerus supracondylar fracture treated with closed reduction and lateral Kirschner wire fixation.Methods:A total of 113 cases of supracondylar fracture of humerus from September 2018 to February 2021 were reviewed.The age,sex,side,classification of fracture,nerve injury of the limb and elbow function at the last follow-up was recorded and analyzed;Baumann angle was examined 1 d and 2 months after surgery.Results:There were 113 cases closed successfully,none of which were incised,and 110 of them were successfully followed up.There was 1 case of radial nerve injury after surgery,and no ulnar nerve injury or cubital varus occurred.Baumann’s comparison between 1 d and 2 months after surgery showed no statistical significance(74.51°±4.12° vs 73.87°±3.62°,P>0.05).According to the modified Flynn criterion,102 cases were excellent,and 8 cases were good at 6 months follow-up.Conclusion:The closed reduction combined with percutaneous lateral Kirschner wire fixation on the treatment of children humerus supracondylar fracture is a reliable and safe technique with high success rate of closed reduction and simple operation,which can provide sufficient stability while avoiding iatrogenic nerve injury.

关 键 词：肱骨髁上骨折 手法复位 骨折稳定性 神经损伤 

分 类 号：R683.41[医药卫生—骨科学]