对肱骨远端等腰三角截骨克氏针张力带内固定治疗儿童肘内翻的疗效观察  

Isosceles triangle osteotomy at distal end of the homeruns with Kirschner wire and tension band internal fixation for children's cubitus varus deformity

作　　者：徐云峰[1] 张骥[1] 徐刚[1] 宋猛[1] 杨征[1] 吕学敏[1] 尤海峰[1] 闫桂森[1] Xu Yunfeng;Zhang Ji;Xu Gang;Song Meng;Yang Zheng;Lv Xuemin;You Haifeng;Yan Guisen(Department of Pediatric Orthopedics, Beijing Jishuitan Hospital, Beijing 100035, China)

机构地区：[1]北京积水潭医院小儿骨科,100035

出　　处：《骨科临床与研究杂志》2022年第4期221-225,共5页Journal Of Clinical Orthopedics And Research

基　　金：北京积水潭医院院级科研基金项目(YGQ-202115)。

摘　　要：目的 探讨肱骨远端等腰三角形截骨矫形克氏针张力带内固定治疗儿童肘内翻畸形的疗效。方法 2020年3月至2021年6月北京积水潭医院小儿骨科采用肱骨远端等腰三角形截骨矫形克氏针张力带内固定治疗肘内翻畸形15例;男11例,女4例;年龄为4.03~10.01(6.26±1.96)岁。术前内翻畸形8.45°~40.28°(19.27°±7.66°)。术前测量双侧提携角,计算所需矫正角度,在PACS系统上进行肱骨远端等腰三角形截骨设计。患儿均行肱骨远端等腰三角形截骨矫形克氏针张力带内固定术和术后石膏外固定。结果 手术时间为55~90(69.1±12.1)min。术中即刻提携角为14.63°~20.51°(16.59°±1.97°)。15例患者均获得6~20(10.1±3.4)个月随访。截骨处均获骨性愈合;愈合时间为4~8(6.7±0.5)周。末次随访时提携角为14.36°~20.06°(16.53°±1.81°)。末次随访Mayo肘关节功能评估手术疗效优良率为93.33%。结论 肱骨远端等腰三角形截骨矫形克氏针张力带固定是矫正儿童肘内翻畸形的一种简易、实用、安全、有效的手术方式。Objective To evaluate the clinical and functional outcomes of the isosceles triangle osteotomy at distal end of the humerus with Kirschner wire and tension band internal fixation for children's cubitus varus deformity.Methods A retrospective analysis of the clinical data of 15 children with cubitus varus deformity treated by the isosceles triangle osteotomy at distal end of the humerus with Kirschner wire and tension band internal fixation in Department of Pediatric Orthopedics,Beijing Jishuitan hospital from March 2020 to June 2021;11 males and 4 females;age ranged from 4.03 to 10.01(6.26±1.96)years.Preoperative varus deformity was 8.45°-40.28°(19.27°±7.66°).Preoperative measurement of the bilateral carrying angles,calculation of the correction angles,the isosceles triangle osteotomy at distal end of the humerus was designed in the PACS.The isosceles triangle osteotomy at distal end of the humerus with Kirschner wire and tension band internal fixation and the plaster external fixation was performed in all cases.Results The operation time was 55-90(69.07±12.05)min.Intraoperative immediate carrying angle ranged from 14.63°to 20.51°(16.59°±1.97°).All the patients were followed up 6-20(10.07±3.37)months.Osseous healing at the site of osteotomies occurred in all the cases within 4-8(6.67±0.52)weeks.At the last follow-up,the carrying angle was 14.36°-20.06°(16.53°±1.81°).At the last follow-up,the excellent and good rate was 93.33%by the Mayo elbow joint function scores.Conclusion Isosceles triangle osteotomy at distal end of the humerus with Kirschner wire and tension band fixation is a practical,reliable,safe and effective operation for children's cubitus varus deformity.

关 键 词：肘内翻 截骨术 内固定术 儿童 

分 类 号：R726.8[医药卫生—儿科]