小切口复位克氏针内固定治疗儿童肱骨外髁骨折  

Small incision reduction and Kirschner wire internal fixation for treatment of pediatric lateral condyle fractures of the humerus

作　　者：莫贤跃 黄勇斌 姜权 蒋荣玉 黎贤发 许昕 廖秀玉 左恩强 MO Xian-yue;HUANG Yong-bin;JIANG Quan;JIANG Rong-yu;LI Xian-fa;XU Xin;LIAO Xiu-yu;ZUO En-qiang(Dept of Pediatric Orthopaedics,Xing′an Jieshou Orthopaedics Hospital,Guilin,Guangxi 541300,China)

机构地区：[1]兴安界首骨伤医院小儿骨科,广西桂林541300

出　　处：《临床骨科杂志》2023年第1期78-82,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨小切口复位克氏针内固定治疗儿童肱骨外髁骨折的疗效。方法采用小切口复位克氏针内固定治疗147例肱骨外髁骨折患儿。记录手术时间、术中出血量、骨折愈合情况、肘关节活动度。采用Hardacre评分评价肘关节功能。结果患儿均获得随访,时间6~18个月。手术时间40~70 min,术中出血量10~20 ml。骨折均解剖复位。切口均一期愈合。骨折均愈合,时间4~6周。末次随访时,肘关节屈曲130°~150°、伸展0°~10°,前臂内旋80°~90°、外旋80°~90°;43例肱骨远端外侧有骨突形成,其中JakobⅡ型16例、Ⅲ型27例,均无明显不适,对患肘活动无影响;采用Hardacre评分评价肘关节功能:优143例,良4例。结论采用小切口复位克氏针内固定治疗儿童肱骨外髁骨折具有显露好、骨折复位准确、固定可靠、创伤小、并发症少等优点。Objective To investigate the clinical effect of small incision reduction and Kirschner wire internal fixation in the treatment of pediatric lateral condyle fractures of the humerus.Methods The 147 children with humeral lateral condyle fractures were treated with small incision reduction and Kirschner wires internal fixation.The operation time,intraoperative bleeding,fracture healing and elbow range of motion were recorded.The elbow function was evaluated by Hardacre score.Results All children were followed up for 6~18 months.The operation time was 40~70 min and the intraoperative bleeding volume was 10~20 ml.All fractures were anatomically reduced.All incisions healed in one stage.All fractures healed in 4~6 weeks.At the last follow-up,range of motion of elbow was flexion with 130°~150°,extension with 0°~10°,forearm internal rotation 80°~90°,forearm external rotation 80°~90°.The 43 cases had bone process formation on the lateral side of the distal humerus,including 16 cases of Jakob typeⅡand 27 cases of Jakob typeⅢ;there was no obvious discomfort and no effect on elbow movement.According to Hardacre evaluation of elbow function,the results were excellent in 143 cases,good in 4.Conclusions Small incision reduction and Kirschner wires internal fixation are used in the treatment of pediatric lateral condyle fractures of the humerus,which have the advantages of good exposure,accurate fracture reduction,reliable fixation,less trauma and few complications.

关 键 词：肱骨外髁骨折 克氏针 切开复位内固定 儿童 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学] R726.834[医药卫生—临床医学]