闭合复位联合改良经鹰嘴内侧旁克氏针交叉内固定治疗儿童肱骨髁上骨折的临床分析  

Clinical Analysis on Closed Reduction Combined with Improved Transolecranon Lateral Kirschner Wire Cross Internal Fixation on the Treatment of Patients with Supracondylar Fractures of the Humerus in Children

作　　者：黄琪钧 崔邦胜 郭锋 HUANG Qijun;CUI Bangsheng;GUO Feng(Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;Shunde Hospital of Guangzhou University of Traditional Chinese Medicine,Foshan 528300,Guangdong China)

机构地区：[1]广州中医药大学,广州510405 [2]广州中医药大学顺德医院

出　　处：《中国中医骨伤科杂志》2023年第1期77-80,83,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：佛山市科技局科研项目(2016AB003913)。

摘　　要：目的:探讨通过闭合复位联合改良经鹰嘴内侧旁克氏针交叉内固定治疗儿童肱骨髁上骨折的临床疗效。方法:回顾性分析2018年9月至2021年11月诊治的20例儿童肱骨髁上骨折患者,麻醉下行闭合复位后,自肱骨外髁穿进2枚克氏针+鹰嘴内侧旁置入1枚克氏针经皮交叉内固定。根据美国特种外科医院(HSS)评分和影像学分析进行功能评估并评价治疗效果。结果:20例患儿均顺利完成手术,手术时间为(62.1±23.1)min,住院时间为(3.1±1.5)d,骨折全部痊愈,愈合时间为5~9周,平均随访时间为7个月(3~12个月)。术后随访,所有患儿未发生钉道感染、缺血性肢体挛缩综合征等相关并发症,也无肘关节内翻、外翻畸形、内固定克氏针松动断裂、肱骨髁内侧皮质劈裂及异位骨化等情况。末次随访时Baumann角为72.6°±3.2°;同时根据HSS肘关节功能评价标准进行评分:优17例,良2例,可1例,差0例,最差0例,优良率为95%,评分结果为(91.9±3.9)分。结论:采用闭合复位联合改良经鹰嘴内侧旁克氏针交叉内固定治疗儿童肱骨髁上骨折,操作相对简便安全、稳定性高,而且能够避免损伤尺神经等并发症,值得临床推广应用。Objective:To explore the clinical efficacy of closed reduction combined with improved transolecranon lateral Kirschner wire cross internal fixation on the treatment of patients with supracondylar fractures of the humerus in children.Methods:A total of 20 children with supracondylar humeral fractures treated from September 2018 to November 2021 were retrospectively analyzed.After closed reduction under anesthesia, patients were treated by percutaneous fixation of 2 Kirschner wires via lateral condyle of humerus and 1 Kirschner wire via paracondyle of medial ulnar olecranon.The Hospital of Specia Surgery(HSS) score and imaging analysis were adopted to evaluate the functional recovery and therapeutic effect.Results:All the 20 cases were successfully operated.The operation time was(62.1±23.1) min, and the hospital stay was(3.1±1.5) d.All patients had their fractures healed, and the fracture healing time was 5 to 9 weeks.Furthermore, they were followed up for 3 to 12 months with 7 months on average.During postoperative follow-up, none of the patients presented pin-tract infections, ischemic convulsion of extremities syndrome and other complications.Meanwhile, they didn’t present cubitus varus or valgus deformity, Kirschner wire loosening or breakage, fracture of medial condyle cortex of humerus, ectopic ossification and other conditions.At the last follow-up, the Baumann’s angle was 72.6°±3.2°,and the score was made according to the HSS elbow function evaluation criteria.Finally the result was excellent in 17 cases, good in 2 cases, fair in 1 case, poor in 0 case and worst in 0 case.Meanwhile, the excellent and good rate was 95%,and the score was(91.9±3.9) points.Conclusion:It is relatively simple, safe and stable, and can avoid complications such as ulnar nerve injury to use closed reduction combined with improved transolecranon lateral Kirschner wire cross internal fixation on the treatment of patients with supracondylar fractures of the humerus in children, which is worthy of clinical promotion and applic

关 键 词：肱骨髁上骨折 尺骨鹰嘴 闭合复位 克氏针 内固定 

分 类 号：R683.41[医药卫生—骨科学]