肘关节造影闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折  

Eblow closed reduction with arthrography and percutaneous Kirschner wire fixation for the treatment of humeral lateral condylar fracture in children

作　　者：任小军[1] 苏春红[2] 陈永刚[1] 移志刚[1] 丁界先 刘文忠[1] 董平[1] 夏亚一[1] REN Xiao-jun;SU Chun-hong;CHEN Yong-gang;YI Zhi-gang;DING Jie-xian;LIU Wen-zhong;DONG Ping;XIA Ya-yi(Dept of Orthopaedics,the Second Hospital of Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学第二医院骨科,甘肃兰州730000 [2]兰州大学第二医院疼痛科,甘肃兰州730000

出　　处：《临床骨科杂志》2024年第1期66-69,共4页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:82060405);甘肃省自然科学基金(编号:22JR11RA057)。

摘　　要：目的探讨肘关节造影闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折的疗效。方法采用肘关节造影闭合复位经皮克氏针固定治疗24例肱骨外髁骨折患儿。记录骨折愈合情况、并发症发生情况、肘关节恢复情况,末次随访时采用Flynn肘关节评分标准评价疗效。结果患儿均获得随访,时间18~24个月。骨折均愈合,时间8~16周。术后未发生肘外翻畸形、肱骨外髁缺血性坏死、骨化性肌炎、缺血性肌挛缩以及神经症状等并发症。末次随访时,4例患儿肘关节功能未完全恢复正常,但不影响生活,Flynn肘关节评分等级均为良;20例肘关节功能均恢复至健侧水平,Flynn肘关节评分等级均为优。结论采用肘关节造影闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折,术中能清楚显示儿童肱骨远端的软骨成分,有助于判断骨折的移位程度和闭合复位的质量,避免不必要的切开复位及并发症的发生。Objective To investigate the effect of the eblow closed reduction with arthrography and percutaneous Kirschner wire fixation in the treatment of humeral lateral condylar fracture in children.Methods The 24 children with humeral lateral condylar fractures were treated by eblow closed reduction with arthrography and percutaneous Kirschner wire fixation.The situation of fracture healing,complications and elbow recovery were recorded,and Flynn elbow function score was used to evaluate the efficacy at the last follow-up.Results All children were followed up for 18~24 months.All fractures were healed within 8~16 weeks.There were no complications such as elbow valgus deformity,ischemic necrosis of the lateral condyle of the humerus,myositis ossificans,ischemic muscle contracture and neurological symptoms.At the last follow-up,in 4 children,the recovery of elbow function was not completely normal,but it did not affect life,the grade of Flynn elbow scores were all good;the elbow function of the other 20 cases was restored to the normal level,the grade of Flynn elbow scores were all excellent.Conclusions In the treatment of humeral lateral condylar fracture in children,the eblow closed reduction with arthrography and percutaneous Kirschner wire fixation can clearly show the cartilage composition of distal humerus in children,which is helpful to judge the displacement degree of fracture and the quality of closed reduction,and avoid unnecessary open reduction and complications.

关 键 词：肘关节造影 闭合复位 经皮固定 儿童肱骨外髁骨折 

分 类 号：R726.8[医药卫生—儿科] R687.3[医药卫生—临床医学] R687.4