内外侧交叉置针与桡侧分散置针内固定术治疗儿童GartlandⅢ型肱骨髁上骨折比较  

Treatment of Gartland typeⅢsupracondylar fractures of humerus in children by internal fixation with the medial-lateral cross pinning versus radial dispersed pinning

作　　者：汪喜顺 刘振江 胡新永 王宁青[1] 任刚 吕海翔 崔寅鹏 WANG Xishun;LIU Zhenjiang;HU Xinyong(Department of Orthopedics,Children’s Hospital,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院骨科,北京市100020

出　　处：《河北医药》2023年第17期2648-2650,2654,共4页Hebei Medical Journal

基　　金：首都儿科研究所附属儿童医院所级课题项目(编号:QN-2019-17)。

摘　　要：目的观察内外侧交叉置针与桡侧分散置针内固定术治疗儿童GartlandⅢ型肱骨髁上骨折的效果。方法收集2019年9月至2022年9月接受桡侧分散置针内固定术治疗的GartlandⅢ型肱骨髁上骨折患儿51例临床资料,纳入A组;另收集同期接受内外侧交叉置针内固定术治疗的GartlandⅢ型肱骨髁上骨折患儿51例临床资料,纳入B组,2组均完成术后6个月的随访。对比2组患儿手术指标及骨折愈合情况、肘关节活动度(肘关节屈曲、伸直、旋前、旋后的角度)、肘关节功能[应用Mayo肘关节功能评分系统(MEPS)评分]以及并发症的发生情况。结果2组患儿住院时间差异无统计学意义(P>0.05);A组手术时间及骨折愈合时间均短于对照组(P<0.05);2组患儿术后6个月肘关节旋前、旋后的角度,差异无统计学意义(P>0.05);A组术后6个月肘关节屈曲角度大于B组,肘关节伸直角度小于B组,差异有统计学意义(P<0.05);A组肘关节功能优良率高于B组(P<0.05);2组患儿术后并发症发生率比较,差异无统计学意义(P>0.05)。结论内外侧交叉置针与桡侧分散置针内固定术在儿童GartlandⅢ型肱骨髁上骨折患儿中均有一定的有效性和安全性,但与内外侧交叉置针相比,桡侧分散置针治疗的患儿手术时间、骨折愈合时间较短,且桡侧置针能有效避免神经损伤,安全性更高,更利于患儿术后早期肘关节功能的恢复。Objective To compare the effect of the medial-lateral cross pinning versus radial dispersed pinning on the treatment of Gartland typeⅢsupracondylar fractures of humerus in children.Methods Clinical data of 51 children with Gartland typeⅢsupracondylar fractures of humerus treated with internal fixation with radial dispersed pinning from September 2019 to September 2022 were retrospectively collected,and they were included in group A.During the same period,fifty-one children with Gartland typeⅢsupracondylar fractures of humerus treated with internal fixation with the medial-lateral cross pinning were included in group B.Children in both groups were followed up for 6 months after operation.The operation indexes,fracture healing,elbow joint range of motion(flexion,extension,pronation and supination),elbow function assessed by the Mayo Elbow Performance Score(MEPS)and complications of the two groups were compared.Results There was no significant difference in the length of stay between the two groups(P>0.05).The operation time and fracture healing time in group A were significantly shorter than those in the control group(P<0.05).There were no significant differences in the pronation and supination angles at 6 months postoperatively between the two groups(P>0.05).The flexion angle of the elbow joint at 6 months postoperatively was significantly larger in group A than that in group B,and the extension angle was significantly smaller(P<0.05).The excellent rate of elbow function in group A was significantly higher than that in group B(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Both the internal fixation with the medial-lateral cross pinning and radial dispersed pinning are effective and safe in children with Gartland typeⅢsupracondylar fractures of humerus.Compared with the medial-lateral cross pinning,radial dispersed pinning is excellent at the shorter operation time,faster fracture healing,and prevention of nerve injury,w

关 键 词：肱骨髁上骨折 内外侧交叉置针 桡侧分散置针 肘关节功能 并发症 

分 类 号：R683.413[医药卫生—骨科学]