闭合复位克氏针内固定治疗儿童肱骨髁上骨折的疗效  

Closed reduction and internal fixation with Kirschner wires for treatment of humeral supracondylar fractures in children

作　　者：胡海波 林伟龙 林宇超 陈建梅 HU Hai-bo;LIN Wei-long;LIN Yu-chao;CHEN Jian-mei(SectionⅠ,Dept of Orthopaedics,the 900th Hospital of Joint Logistic Support Force of CPLA,Fuzhou,Fujian 351000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇〇医院骨一科,福建福州351000 [2]中国融通医疗集团莆田第九十五医院骨一科,福建莆田351100

出　　处：《临床骨科杂志》2023年第4期552-555,共4页Journal of Clinical Orthopaedics

基　　金：福建省莆田市科技局计划项目(编号:2019SJ001)。

摘　　要：目的 探讨闭合复位克氏针内固定治疗儿童肱骨髁上骨折的疗效。方法 在C臂机辅助下行闭合复位克氏针内固定治疗150例GartlandⅢ型肱骨髁上骨折患儿。记录手术时间、术后3 d Baumann角、骨折愈合时间、肘关节功能及活动度。结果 患儿均获得随访,时间3~12个月。手术时间40~50(46.7±5.4)min,术后3 d Baumann角2°~6°(2.5°±0.8°)。骨折均愈合,时间48~62(54.6±5.4) d。术后3个月采用肘关节Flynn评分评价疗效:优138例,良8例,可4例,优良率97.33%。末次随访时,患儿肘关节屈曲120°~140°、伸直0°~8°,前臂旋前80°~90°、旋后70°~80°。145例术后桡动脉博动恢复或改善,患侧末梢血运良好;5例患侧末梢血运良好,桡动脉博动于术后3~5 d恢复正常。结论 闭合复位克氏针内固定治疗儿童肱骨髁上骨折术后并发症少,患儿功能恢复好;术中使用C臂机透视能够清晰地了解骨折移位情况,可有效保障手术安全及固定效果。Objective To investigate the effect of closed reduction and Kirschner wire internal fixation on humeral supracondylar fractures in children.Methods The 150 children with Gartland type-Ⅲhumeral supracondylar fractures were treated with closed reduction and Kirschner wire fixation assisted with C-arm machine.Operation time,postoperative 3 d Baumann angle,fracture healing time,elbow function and its range of motion were recorded.Results All patients were followed up for 3~12 months.The operation time was 40~50(46.7±5.4)min,Baumann angle was 2°~6°(2.5°±0.8°)at 3 d postoperation.All the fractures healed in 48~62(54.6±5.4)d.At three months after operation,Flynn score was used to evaluate the curative effect of the elbow joint:excellent in 138 cases,good in 4,fair 2,and the excellent and good rate was 97.33%.At the last follow-up,the patient had elbow flexion of 120°~140°,extension of 0°~8°,forearm pronation of 80°~90°and supination of 70°~80°.After the operation,the radial artery was recovered or improved in 145 cases,with good peripheral blood circulation of the affected side.The 5 patients had good peripheral blood supply,and the radial artery returned to normal at 3~5 d after surgery.Conclusions Closed reduction and Kirschner wire internal fixation in the treatment of humeral supracondylar fracture in children have fewer complications and good functional recovery.Intraoperative fluoroscopy with C-arm machine can clearly understand the displacement of fractures,which can effectively ensure the safety of surgery and fixation effect.

关 键 词：闭合复位 克氏针固定 肱骨髁上骨折 肘关节功能 儿童 

分 类 号：R726.834[医药卫生—儿科] R726.873[医药卫生—临床医学]