经肱骨内髁小切口克氏针交叉内固定治疗儿童肱骨髁上骨折  

Kirschner wire cross internal fixation for treatment of humeral supracondylar fracture in children via small incision in the medial condyle of the humerus

作　　者：张冲 任彩玲 陈亚娟 张鹏 谷萌 赵方方 侯文才 ZHANG Chong;REN Cai-ling;CHEN Ya-juan;ZHANG Peng;GU Meng;ZHAO Fang-fang;HOU Wen-cai(Dept of Orthopaedics,the People′s Hospital of Chengwu County,Heze,Shandong 274200,China)

机构地区：[1]成武县人民医院骨科,山东菏泽274200 [2]成武县人民医院普通外科,山东菏泽274200 [3]单县东大医院骨科,山东菏泽274300

出　　处：《临床骨科杂志》2023年第1期74-77,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨经肱骨内髁小切口克氏针交叉内固定治疗儿童肱骨髁上骨折的疗效。方法采用经肱骨内髁小切口置入克氏针交叉内固定治疗21例肱骨髁上骨折患儿。记录手术相关指标,采用Khalfayan评分评价肘关节功能恢复情况。结果患儿均获得随访,时间6~45个月。手术时间40~60 min。术后无尺神经损伤症状、肘关节骨化性肌炎及骨萎缩体征表现、肘内翻畸形、骨折再次错位及移位等情况发生。骨折均愈合,时间4~13周。末次随访时,肘关节活动度:屈曲135°~145°,伸直0°~5°;携物角7°~10°;前臂旋前85°~90°,旋后80°~85°;采用Khalfayan评分评价肘关节功能恢复优良率为20/21。结论经肱骨内髁小切口克氏针交叉内固定治疗儿童肱骨髁上骨折,手术方法简单、可靠,并发症少,具有定位精确、避免尺神经损伤、切口无需缝合等优势。Objective To investigate the curative effect of Kirschner wire cross internal fixation for treatment of humeral supracondylar fracture in children with a small incision in the medial condyle of the humerus.Methods The 21 patients with humeral supracondylar fractures were treated with cross-insertion of Kirschner wires via a small incision in the medial condyle of the humerus.The related indicators of the surgeries were recorded,and function recovery of the elbow joint was evaluated by Khalfayan evaluation criteria.Results All patients were followed up for 6~45 months after operation.The operation time was 40~60 min.There was no symptoms of ulnar nerve injury,elbow joint myositis ossificans and signs of bone atrophy,cubitus varus deformity or redislocation and displacement of fractures after operation.All fractures healed within 4~13 weeks after operation.At the last follow-up,eblow range of motion was that the flexion was 135°~145°,extension was 0°~5°;elbow carriage angle was 7°~10°;forearm pronation was 85°~90°,forearm supination was 80°~85°.The elbow joint function recovery rate assessed by Khalfayan evaluation criteria was 20/21.Conclusions Kirschner wire cross fixation through the small incision of the medial condyle of the humerus is used to treat the humeral supracondylar fractures in children,which is a simple and reliable method,with few complications,which has the following advantages of accurate positioning,avoidance of ulnar nerve injury,and no need for suture of the incision.

关 键 词：肱骨内髁小切口 儿童肱骨髁上骨折 克氏针交叉固定 

分 类 号：R726.834[医药卫生—儿科] R687.32[医药卫生—临床医学]