克氏针撬拨复位技术在儿童桡偏型肱骨髁上骨折治疗中的应用  

The application of Kirschner wire prying reduction technique on the humeral supracondylar fracture of radial deviation type in children

作　　者：肖元 刘昕[1] 周英[1] 叶家军[1] 邓志强[1] 任波 XIAO Yuan;LIU Xin;ZHOU Ying;YE Jia-jun;DENG Zhi-qiang;REN Bo(Dept of Pediatric Orthopaedics,Sichuan Provincial Orthopaedic Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省骨科医院儿童骨科,四川成都610041

出　　处：《临床骨科杂志》2025年第2期235-239,共5页Journal of Clinical Orthopaedics

基　　金：国家中医药管理局(省部级课题)项目(编号:SATCM-2015-BZ〔200〕)。

摘　　要：目的探讨克氏针撬拨复位技术辅助闭合复位克氏针内固定治疗儿童桡偏型肱骨髁上骨折的疗效。方法将36例桡偏型肱骨髁上骨折患儿根据治疗方式不同分为对照组(采用常规闭合复位克氏针内固定治疗,20例)和观察组(采用克氏针撬拨复位技术辅助闭合复位克氏针内固定治疗,16例)。比较两组切开复位率、手术时间、术中透视次数、并发症发生情况以及末次随访时肘关节提携角、两侧肘关节屈伸范围比。结果患儿均获得随访,时间3~14(6.8±2.3)个月。切开复位率观察组低于对照组(P<0.05);手术时间、术中透视次数观察组短(少)于对照组(P<0.01);末次随访时肘关节提携角、两侧肘关节屈伸范围比两组比较差异均无统计学意义(P>0.05)。对照组2例、观察组1例克氏针针道浅表感染;两组均无肘内翻、神经血管损伤、骨化性肌炎、筋膜间室综合征、骨折不愈合等相关并发症发生。结论克氏针撬拨复位技术辅助闭合复位克氏针内固定治疗儿童桡偏型肱骨髁上骨折安全、有效,可缩短手术时间,减少术中透视次数,降低切开复位率,且不增加并发症发生风险。Objective To investigate the effect of Kirschner wire prying reduction technique assisted closed reduction Kirschner wire internal fixation on the humeral supracondylar fracture of radial deviation type in children.Methods The 36 children with humerus supracondylar fractures of radial deviation type were divided into control group(20 cases were performed with conventional closed reduction and Kirshcner wire internal fixation)and observation group(16 cases were adopted with Kirschner wire prying reduction technique assisted closed reduction Kirschner wire internal fixation),according to different treatment methods.The open reduction rate,operation time,intraoperative fluoroscopy frequency,complications,carring angle of elbow joint at last follow-up,flexion-extension range of elbow joint on both sides of the last follow-up were compared between the two groups.Results All patients were followed up for 3~14(6.8±2.3)months.The open reduction rate in the observation group was lower than that in the control group(P<0.05).Operation time and intraoperative fluoroscopy frequency in observation group were shorter(less)than those in control group(P<0.01).At the last follow-up,there were no statistical differences between the two groups in the carring angles of elbow joint and flexion-extension range of elbow joint on both sides(P>0.05).The superficial infection occurred in 2 cases of control group and 1 case in observation group.There were no complications related to cubital varus,neurovascular injury,ossification myositis,compartment syndrome and nonunion in both groups.Conclusions It is a safe and effective technique to treat the the humeral supracondylar fracture of radial deviation type in children with Kirschner wire prying reduction assisted closed reduction Kirschner wire internal fixation,which can shorten the operation time,reduce the intraoperative fluoroscopy times,reduce the open reduction rate,and do not increase the risk of complications.

关 键 词：撬拨复位 肱骨髁上骨折 切开复位 闭合复位 克氏针内固定 儿童 

分 类 号：R726.834.1[医药卫生—儿科] R726.873.2[医药卫生—临床医学]