微型外固定支架与交叉克氏针治疗儿童肱骨髁上骨折对比研究  

The Comparative Study of Micro External Fixator and Medial and Lateral Cross Kirschner Wires Fixation for Treatment of Humeral Supracondylar Fracture in Children

作　　者：范江荣[1] 许益文[1] 郑勇[1] 游景扬[1] 石振[1] 郑波[1] 阮家诚 FAN Jiangrong;XU Yiwen;ZHENG Yong;YOU Jingyang;SHI Zhen;ZHENG Bo;RUAN Jiacheng(Department of Orthopedics,the First Affiliated Hospital of Hubei University of Science and Technology(Xianning Central Hospital),Xianning 437100,Hubei China)

机构地区：[1]湖北科技学院附属第一医院(咸宁市中心医院)骨科,湖北咸宁437100

出　　处：《中国中医骨伤科杂志》2022年第7期44-48,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：咸宁市中心医院院级课题(2016XYB001)。

摘　　要：目的:探讨微型外固定支架治疗Gartland Ⅲ型儿童肱骨髁上骨折的临床疗效及优势。方法:以2017年1月至2020年6月本院收治的80例Gartland Ⅲ型儿童肱骨髁上骨折为研究对象,根据所采用不同固定方式分为两组:其中治疗组(外固定支架组)41例,对照组(内外侧交叉克氏针组)39例;治疗组采用闭合复位微型外固定支架结合外侧1或2枚克氏针固定,对照组采用闭合复位内外侧交叉克氏针固定。对比两组手术时间、透视次数、提携角、术后肘关节功能。结果:两组患者均于全身麻醉下采用闭合复位成功。外固定支架组手术时间及透视次数均明显少于内外侧交叉克氏针组,差异有统计学意义(P<0.01);术后提携角治疗组高于对照组,差异有统计学意义(P<0.01);两组术后肘关节功能Flynn评分基本相当,差异无统计学意义(P>0.05)。治疗组无一例发生尺神经损伤,无肘内翻畸形发生,对照组有1例发生尺神经损伤,术后2个月自行恢复,2例发生轻度肘内翻,未处理。结论:微型外固定支架与内外侧交叉针经皮固定均能微创治疗儿童肱骨髁上骨折,术后肘关节功能相当,外固定架组术中平均手术时间及透视次数较对照组明显减少,肘内翻发生率低,医务人员在放射线下暴露时间明显减少,疗效满意。Objective:To study the advantages of external fixator on treatment of Gartland type Ⅲ humeral supracondylar fracture.Methods:Eighty pediatric Gartland Ⅲ humeral supracondylar fracture patients in hospital from January 2017 to June 2020 were included in the study.The patients were divided into two groups by different internal fixator.41 patients were grouped as the treated group and the other 39 patients were grouped as the control group.Patients in the treated group(external fixation)were treated with closed reduction and were fixed with micro external fixators combined with 1 or 2 Kirschner wires.Patients in the control group(medial and lateral cross Kirschner wires fixation)were treated with closed reduction with merely medial and lateral Kirschner wire fixation.Operation time,times of X-ray usage,carrying angle,postoperative function of two groups were compared.Results:Patients of both groups acquired successful closed reduction under general anesthesia.Operation time and X-ray usage of the treated group were both significantly less than the control group(P<0.01),carrying angle of the treated group was significantly bigger than that of the control group(P<0.01).The Flynn scores of the elbow joint function of the two groups were basically the same,and the difference was not statistically significant(P>0.05).No ulnar nerve injury and cubitus varus was observed in the treated group,while 1 case of ulnar nerve injury was observed in the control group,which healed spontaneously post operation.Two cases of cubitus varus were observed in the control group,no further treatment was given.Conclusion:Both micro external fixator and percutaneous cross wires can be used to minimally invasively treat pediatric humeral supracondylar fractures,and joint function after treatment of these two measures are similar,but the external fixation group has relatively less operation time and X-ray usage,morbidity of cubitus varus is lower,X-ray exposure of the medical staff is significantly reduced,and curative efficacy is satisfact

关 键 词：外固定架 微创 儿童 肱骨髁上骨折 克氏针 

分 类 号：R683.41[医药卫生—骨科学]