肘内侧小切口联合操纵杆技术治疗肱骨内上髁骨折的疗效分析  

A minor medial approach plus joystick technique in the treatment of displaced medial epicondyle fracture:a report of efficacy analysis

作　　者：刘永 孙军[1] 阚利胜 车伟 Liu Yong;Sun Jun;Kan Lisheng;Che Wei(Department of Pediatric Orthopedic,Affiliated Provincial Pediatric Hospital of Anhui Medical University,Hefei 230032,China;No.91126 Hospital of Chinese PLA,Dalian 116041,China)

机构地区：[1]安徽医科大学附属省儿童医院骨科,合肥230032 [2]解放军第91126部队医院,大连116041

出　　处：《中华小儿外科杂志》2022年第5期449-452,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨经肘内侧小切口联合空心钉操纵杆技术治疗儿童肱骨内上髁骨折的手术方法和临床疗效。方法收集2017年1~12月安徽医科大学附属省儿童医院收治的26例肱骨内上髁骨折患儿的临床资料。其中男19例,女7例;左侧10例,右侧16例;受伤时年龄为(11.3±2.2)岁;受伤至入院时间为(2.6±3.9)d。术前常规行肘关节正侧位X线片;术中行肘内侧小切口联合空心钉操纵杆技术实现骨折解剖复位和牢固固定;末次随访采用Mayo肘关节功能评分标准(Mayo elbow performance score,MEPS)评估肘关节功能,并观察并发症发生情况。结果根据Papavasiliou分型:Ⅱ型骨折9例、Ⅲ型13例、Ⅳ型4例;MEPS评分为(94±5)分(85~100分)。所有患儿均获随访,随访(21.7±11.6)个月;骨折平均愈合时间2.5个月。末次随访所有患儿术后切口均一期愈合,无骨不连、延迟愈合、关节不稳等并发症发生。结论肘内侧小切口联合空心钉操纵杆技术是一种治疗儿童肱骨内上髁骨折的可靠有效方法,可以实现解剖复位和牢固固定和满意疗效。Objective To retrospectively evaluate the clinical outcomes of patients with displaced medial epicondyle fracture managed with joystick technique using a cannulated screw through a minor medial approach.Methods From January 2017 to December 2017,clinical data were retrospectively reviewed for 26 children hospitalized with displaced medial epicondyle fracture.There were 19 boys and 7 girls.The involved side was left(n=10)and right(n=16).The age at the time of injury was(11.3±2.2)years and the time from injury to admission(2.6±3.9)days.Preoperative radiographic evaluation was performed routinely for affected elbow joint.Anatomical reduction and robust fixation were achieved by joystick technique with a cannulated screw intraoperatively.Clinical evaluations were performed by the Mayo Elbow Performance Score(MEPS)and the complications recorded at the latest follow-up.Results Based upon the Papavasiliou criteria,fracture types wereⅡ(n=9),Ⅲ(n=13)andⅣ(n=4).And the mean MEPS score was(94±5)(85-100)points.The average follow-up period was(21.7±11.6)months and the mean time of bone healing 2.5 months.All wounds healed primarily.There was no onset of nonunion,delayed union or joint instability.Conclusion A minor medial approach plus joystick technique with a cannulated screw is both reliable and effective for displaced medial epicondyle fracture in children.With a satisfactory outcome,it maintains anatomical reduction and robust fixation.

关 键 词：肱骨骨折 骨折固定术 儿童 

分 类 号：R726.8[医药卫生—儿科]