经皮交叉克氏针内固定治疗儿童Gartland Ⅲ型肱骨髁上骨折的疗效  

Effect of percutaneous cross Kirschner wire internal fixation on children with Gartland typeⅢhumeral supracondylar fracture

作　　者：磨焕鹏 胡东辉 邓妙芳 张亚忠 何晖 MO Huan-peng;HU Dong-hui;DENG Miao-fang;ZHANG Ya-zhong;HE Hui(Department of Upper Limb Osteoarthrosis,Wuzhou Hospital of Traditional Chinese Medicine,Guangxi Zhuang Autonomous Region,Nanning 543002,China)

机构地区：[1]广西壮族自治区梧州市中医医院上肢骨关节科,广西南宁543002

出　　处：《河北医科大学学报》2023年第2期184-188,235,共6页Journal of Hebei Medical University

摘　　要：目的探讨经皮交叉克氏针内固定治疗儿童GartlandⅢ型肱骨髁上骨折的临床疗效。方法回顾性分析GartlandⅢ型肱骨髁上骨折患儿149例,按照不同治疗方案分为内固定组76例和外固定组73例,内固定组予以经皮交叉克氏针内固定治疗,外固定组予以石膏或小夹板外固定治疗。术后6周,比较2组肘关节活动度、提携角;术后6个月随访,采用Flynn肘关节评分评价2组的优良率,比较2组患儿的骨折愈合时间、肘内翻畸形发生率及不良预后总发生率;并测量2组患儿术前、拆除石膏后和末次随访的Baumann角。结果术后6周,内固定组的肘关节活动度、提携角改善均明显优于外固定组(P<0.05);术后6个月,内固定组的Flynn肘关节评分优良率明显高于外固定组(P<0.05)。内固定组在拆除石膏后、末次随访时测量的Baumann角均明显低于内固定组(P<0.05)。且内固定组的骨折愈合时间明显短于外固定组(P<0.05)。内固定组的肘内翻畸形发生率、不良预后总发生率均明显低于外固定组(P<0.05)。结论经皮交叉克氏针内固定治疗儿童GartlandⅢ型肱骨髁上骨折的临床疗效确切,可有效改善患儿预后,有利于肘关节功能早期恢复。Objective To investigate the clinical effect of percutaneous cross Kirschner wire internal fixation for children with Gartland typeⅢhumeral supracondylar fracture.Methods A total of 149 children with Gartland typeⅢhumeral supracondylar fracture were retrospecitvely analyzed,and divided into internal fixation group(n=76)and external fixation group(n=73)according to different treatment regimens.The internal fixation group was treated with percutaneous cross Kirschner wire internal fixation,and the external fixation group received plaster or small splint external fixation.At 6 weeks after operation,the elbow joint range of motion(ROM)and lifting angle of the two groups were compared.They were followed up for 6 months after operation.The Flynn elbow scoring standard was used to evaluate the excellent and good rates of the two groups at 6 months after operation.The fracture healing time,incidence of cubitus varus deformity and overall incidence of poor prognosis were observed in the two groups,and the Baumann Angle was measured before operation,after plaster removal and at the last follow-up.Results At 6 weeks after operation,the improvement of elbow joint ROM and lifting angle in the internal fixation group was significantly better than that in the external fixation group(P<0.05).At 6 months after operation,the excellent and good rate of Flynn elbow score in the internal fixation group was significantly higher than that in the external fixation group(P<0.05).Baumann Angle measured in the internal fixation group after plaster removal and at the last follow-up was obviously lower than that in the external fixation group(P<0.05).And the fracture healing time in the internal fixation group was distinctly shorter than that of the external fixation group(P<0.05).The incidence of cubitus varus deformity and the total incidence of poor prognosis in the internal fixation group were visibly lower than those in the external fixation group(P<0.05).Conclusion Percutaneous cross Kirschner wire internal fixation in the treatmen

关 键 词：肱骨骨折 骨折固定术 内 儿童 

分 类 号：R683.41[医药卫生—骨科学]