新型组合小儿肱骨髁上骨折复位架的应用  

New combined reduction frame for supracondylar fractures of humerus in children

作　　者：贵鹏 张立 闫泽正 刘宇军[1] 周斌 贾斌 肖远琼[1] 谭东澜 GUI Peng;ZHANG Li;YAN Ze-zheng;LIU Yu-jun;ZHOU Bin;JIA Bin;XIAO Yuan-qiong;TAN Dong-lan(Nanxishan Hospital,Guangxi Zhuang Autonomous Region,Gui-lin541000,China;People's Hospital of Guilin City,Guilin541000,China)

机构地区：[1]广西壮族自治区南溪山医院,广西桂林541000 [2]广西壮族自治区桂林市人民医院,广西桂林541000

出　　处：《中国矫形外科杂志》2023年第18期1713-1716,共4页Orthopedic Journal of China

基　　金：广西医疗卫生重点培育学科建设项目;桂林市科学研究与技术开发计划项目(编号:2020011207-7)。

摘　　要：[目的]介绍新型组合式小儿肱骨髁上骨折复位架在小儿肱骨髁上骨折内固定的手术技术及初步临床效果。[方法]2019年1月—2022年3月采用新型组合式小儿肱骨髁上骨折复位架进行髁上骨折闭合复位克氏针内固定术30例,患儿取侧卧位,通过体位架实现利用患者胸壁进行反方向对抗牵引,单人手法复位后依靠前臂重量悬垂固定,透视满意后克氏针固定骨折断端。[结果]所有患者均顺利完成手术,无神经损伤等并发症,手术时间(28.0±3.7) min,C形臂X线机曝光次数为(4.5±0.9)次,术中出血量(23.5±6.9) ml,平均住院时间(3.5±0.9) d。术后1个月门诊随访,30例患儿肘关节功能Flynn评分优良率为98.7%,术后骨折均完全愈合,均于术后1个月取出内固定。[结论]肱骨髁上骨折患儿利用复位架进行手术治疗,可实现单人牵引复位操作,操作简便,减少医护人员和患者术中放射暴露,减少手术时间和费用。[Objective]To introduce the surgical technique and preliminary clinical results of a new combined reduction frame for su⁃pracondylar fractures of the humerus in children.[Methods]A retrospective study was made on 30 children who received closed reduction under the new combined reduction frame and percutaneous internal fixation with Kirschner wire for humeral supracondylar fractures.The patients were placed in the lateral decubitus position with the affected limb and body rested on the new combined reduction frame that at⁃tached with the operating table to resist the traction force in the opposite direction.After manual reduction of the fracture,its position was temporarily maintained by the forearm weight in suspension with elbow flexion at 90 degrees.As a satisfactory reduction was checked by fluoroscopy,Kirschner wires were percutaneously placed in a cross manner to fix the fracture stably.[Results]All the patients got operation conducted smoothly without complications such as nerve injury,whereas with operation time of(28.0±3.7)min,fluoroscopy of(4.5±0.9)times,intraoperative blood loss of(23.5±6.9)ml and hospital stay of(3.5±0.9)days.A month after operation,all the children got complete fracture healing with excellent and good rate of 98.7%based on Flynn score,and had the implant removed.[Conclusion]Utilizing this new combine reduction frame,fracture reduction and internal fixation do be realized by single-person operation for humeral supracondylar frac⁃tures in children,which reduces the need for medical staff,declines radiation exposure,shorten the operation time and save cost of patients.

关 键 词：儿童 肱骨髁上骨折 闭合复位 骨折复位架 

分 类 号：R683.41[医药卫生—骨科学]