单人急诊闭合复位经皮交叉克氏针内固定治疗儿童肱骨髁上骨折  

Treatment of humeral supracondylar fractures in children with single emergency closed reduction and percutaneous cross Kirschner wire fixation

作　　者：年争好 张中礼[2] 孙军 唐淼[1] 许康永 刘长征[1] NIAN Zheng-hao;ZHANG Zhong-li;SUN Jun;TANG Miao;XU Kang-yong;LIU Chang-zheng(Dept of Orthopaedics,Suzhou Hospital Affiliated of Anhui Medical University,Suzhou,Anhui 234000,China)

机构地区：[1]安徽医科大学附属宿州医院骨科,安徽宿州234000 [2]天津市天津医院小儿骨科,天津300211 [3]安徽省儿童医院小儿骨科,安徽合肥230051

出　　处：《临床骨科杂志》2024年第2期226-229,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨单人急诊闭合复位经皮交叉克氏针内固定治疗儿童肱骨髁上骨折的疗效。方法采用单人急诊闭合复位经皮交叉克氏针内固定治疗35例肱骨髁上骨折患儿。记录骨折愈合情况、并发症发生情况、肘关节及腕关节活动度,采用Flynn标准评价肘关节功能。结果患儿均获得随访,时间3~18个月。术后均无针道感染、肘关节内翻或外翻畸形等并发症,1例术后发生环、小指麻木,不能完全伸直,于术后第2天拔除尺侧克氏针后症状逐渐消失。35例骨折均愈合,时间4~6周。末次随访时,患儿均无明显疼痛不适;肘关节伸直0°~8°、屈曲115°~145°,前臂旋前75°~85°、旋后70°~80°,腕关节背伸35°~60°、掌屈50°~60°,患侧活动度均与健侧无明显区别;采用Flynn标准评价肘关节功能:优29例,良4例,可2例,优良率94.3%。结论单人急诊闭合复位经皮交叉克氏针内固定治疗儿童肱骨髁上骨折具有创伤小、并发症少等优点,可及时减轻患儿痛苦,术后肘关节功能恢复良好。Objective To investigate the effect of single emergency and closed reduction and percutaneous cross Kirschner wire fixation for treatment of humeral supracondylar fractures in children.Methods The 35 children with humeral supracondylar fractures were treated with single emergency closed reduction and percutaneous cross Kirschner wire internal fixation.The fracture healing,complications and the range of motion of elbow joint and wrist joint were recorded,and the elbow function was evaluated by Flynn criterion.Results All 35 patients were followed up for 3~18 months.After surgery,there were no complications such as needle tract infection,the cubitus varus or valgus deformity.One patient had numbness of ring finger,little finger and could not fully straighten,the symptoms gradually disappeared after removal of the ulnar Kirschner wire on the 2nd day postoperation.The 35 cases were all healed in 4~6 weeks.At the last follow-up,the children had no obvious discomfort;and the range of motion of elbow joint reached extension with 0°~8°,flexion with 115°~145°,forearm pronaiton with 75°~85°,and supination with 70°~80°,and the wrist joint dorsiflexion with 35°~60°,and the palmar flexion with 50°~60°,and the range of motion of the affected side and the healthy side had no obvious difference,the eblow function evaluated with Flynn criterion was excellent in 29 cases,good in 4 cases and poor 2 cases,with and excellent-good rate of 94.3%.Conclusions For treatment of humeral supracondylar fractures in children,single emergency and closed reduction percutaneous cross Kirschner wire internal fixation has the advantages of less trauma and few complications,and which can relieve the pain of children at the first time,the elbow function is restored well after operation.

关 键 词：单人急诊 闭合手法复位 肱骨髁上骨折 经皮交叉克氏针内固定 儿童 

分 类 号：R726.184.1[医药卫生—儿科] R726.873.2[医药卫生—临床医学]