单人手法整复联合经皮克氏针内固定治疗GartlandⅢ型儿童肱骨髁上骨折的效果  

Effect of Single Manual Rectification Combined with Percutaneous Kirschner Wire Internal Fixation in the Treatment of Gartland TypeⅢSupracondylar Humeral Fractures Children

作　　者：柳锦华 刘远文 陈白梅 LIU Jinhua;LIU Yuanwen;CHEN Baimei(Luoding Traditional Chinese Medicine Hospital,Luoding 527200,China;不详)

机构地区：[1]罗定市中医院,广东罗定527200

出　　处：《中外医学研究》2024年第35期112-115,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：云浮市科技计划项目(WS2022030702)。

摘　　要：目的:探讨通过单人手法整复结合经皮克氏针内固定治疗闭合性GartlandⅢ型儿童肱骨髁上骨折的临床效果。方法:选取2022年1月—2023年5月罗定市中医院36例GartlandⅢ型肱骨髁上骨折患儿,均采用单人手法整复联合经皮克氏针内固定。观察并记录患儿的手术时间、住院时间、骨折愈合时间、肘关节活动度、前臂活动度及并发症。末次随访时采用Flynn肘关节评分标准评价临床疗效。结果:36例患儿手术时间31~53 min,中位手术时间41 min。患儿均获随访,随访时间4~12个月,中位随访时间9个月。骨折均愈合,临床愈合时间36~52 d,中位临床愈合时间43 d;肘关节伸直活动度125°~147°,中位肘关节伸直活动度137°;肘关节屈曲活动度4°~9°,中位肘关节屈曲活动度6°;前臂旋前活动度71°~79°,中位前臂旋前活动度76°;前臂旋后活动度70°~78°,中位前臂旋后活动度74°。患儿均未发生克氏针松动、针口感染、神经血管损伤、肘内翻畸形等并发症。末次随访时,采用Flynn肘关节功能评价标准评价临床疗效,优25例,良9例,可2例,优良率为94.4%。结论:单人手法整复联合经皮克氏针内固定治疗GartlandⅢ型儿童肱骨髁上骨折的效果良好,并发症少,骨折愈合良好,肘关节功能恢复好。Objective:To investigate the clinical efficacy of single manual rectification combined with percutaneous Kirschner wire internal fixation in the treatment of Gartland typeⅢsupracondylar humeral fractures children.Method:From January 2022 to May 2023,36 children with Gartland typeⅢsupracondylar humeral fractures in Luoding Traditional Chinese Medicine Hospital were selected,who were treated with single manual rectification combined with percutaneous Kirschner wire internal fixation.The operation time,hospital stay,fracture healing time,range of motion of the elbow,range of motion of the forearm and complications of all patients were observed and recorded.The Flynn elbow scoring standard was used to evaluate the clinical efficacy at the last follow-up.Result:The 36 cases had an operation time of 31-53 minutes,with a median of 41 minutes.All children were followed up for 4-12 months,with a median of 9 months.All fractures healed,the clinical healing time was 36-52 d,with a median of 43 d.The range of motion for elbow extension was 125°to 147°,with a median of 137°;while the range for elbow flexion was 4°to 9°,with a median of 6°.Forearm pronation had a range of motion from 71°to 79°,with a median of 76°;and forearm supination had a range from 70°to 78°,with a median of 74°.There were no complications such as Kirschner's needle loosening,needle site infection,neurovascular injury or cubit varus deformity.At the final follow-up evaluation using Flynn's criteria for elbow joint function assessment,there were excellent results in 25 cases,good results in 9 cases,and fair results in 2 cases,the rate of excellent and good was 94.4%.Conclusion:The treatment of Gartland typeⅢhumeral supracondylar fracture in children with single manual rehabilitation combined with percutaneous Kirschner wire internal fixation has good curative effect,few complications,good fracture healing and good elbow joint function recovery.

关 键 词：单人手法整复 克氏针 经皮内固定 儿童GartlandⅢ型肱骨髁上骨折 

分 类 号：R68[医药卫生—骨科学]