| 急诊闭合复位经皮克氏针内固定治疗Gartland Ⅱ-Ⅲ型儿童肱骨髁上骨折 |
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投稿时间：2015-01-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 范江荣 |
FAN Jiang-rong |
华中科技大学同济咸宁医院骨科, 湖北 咸宁 437100 |
Department of Orthopedics, Tongji Xianning Hospital of Huazhong University of Science and Technology, Xianning 437100, Hubei, China |
fansir003@163.com |
| 许益文 |
XU Yi-wen |
华中科技大学同济咸宁医院骨科, 湖北 咸宁 437100 |
Department of Orthopedics, Tongji Xianning Hospital of Huazhong University of Science and Technology, Xianning 437100, Hubei, China |
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| 郑勇 |
ZHENG Yong |
华中科技大学同济咸宁医院骨科, 湖北 咸宁 437100 |
Department of Orthopedics, Tongji Xianning Hospital of Huazhong University of Science and Technology, Xianning 437100, Hubei, China |
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| 游景扬 |
YOU Jing-yang |
华中科技大学同济咸宁医院骨科, 湖北 咸宁 437100 |
Department of Orthopedics, Tongji Xianning Hospital of Huazhong University of Science and Technology, Xianning 437100, Hubei, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第5期，第464-467页 |
| DOI：10.3969/j.issn.1003-0034.2015.05.017 |
| 基金项目: |
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中文摘要:
目的:探讨急诊闭合复位经皮克氏针内固定治疗Gartland Ⅱ-Ⅲ型儿童肱骨髁上骨折的临床疗效及相关危险因素分析。
方法:回顾分析2008年1月至2013年6月急诊行闭合复位经皮克氏针交叉固定治疗112例Gartland Ⅱ-Ⅲ型儿童肱骨髁上骨折的临床资料。其中男72例,女40例;年龄2～11岁,平均6.2岁;Gartland Ⅱ型骨折74例,Ⅲ 型38例;受伤至手术时间2.5～8 h,平均4.6 h.术后伸肘100°石膏固定4～6周后拆除石膏、拔除克氏针,行功能锻炼。
结果:112例术后获得随访,时间6～60个月,平均12个月。所有骨折达到骨性愈合,术后末次随访按Flynn肘关节功能评价,优86例,良23例,一般3例,优良率97.3%.3例发生轻度肘内翻畸形,无须矫形处理。无针道感染、医源性尺神经损伤、骨筋膜室综合征及Volkmann缺血性挛缩等并发症发生。
结论:闭合复位经皮克氏针固定具有维持复位确切、固定牢靠、并发症少、急诊手术患儿痛苦少、闭合复位成功率高等优点,是治疗移位型儿童肱骨髁上骨折安全、有效的方法。 |
| 【关键词】肱骨骨折 儿童 骨折固定术,内 外科手术 |
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| Emergency closed reduction and percutaneous Kirschner wire fixation for treatment of Gartland type Ⅱ-Ⅲ supracondylar fractures of the humerus in children |
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ABSTRACT
Objective:To analyze the clinical effect and related risk factors of Gartland type Ⅱ-Ⅲ supracondylar fractures of humerus in children in the emergency closed reduction and percutaneous Kirschner wire fixation.
Methods:From January 2008 to June 2013,112 children of Gartland type Ⅱ to Ⅲ supracondylar humeral fractures were treated in children in emergency closed reduction and percutaneous K-wire fixation,including 72 males and 40 females with an average age of 6.2 years old ranging from 2 to 11 years old. Among them,74 cases were in Gartland type Ⅱ fractures,38 cases were in type Ⅲ;The duration from injury to surgery time was 2.5 to 8 hours (averaged 4.6 hours). Elbow cast was applied after operation with the elbow extended of 100 degrees for 4 to 6 weeks,then the gypsum and Kirschner wires were removed.
Results:All patients were follow-up from 6 to 60 months (averaged 12 months). All fractures reached clinical healing. The final follow-up was assessed by Flynn criteria,the result was excellent in 86 cases,good in 23 cases,general in 3 cases,excellent and good rate was 97.3%. Three patients had mild cubitus varus deformity without orthopedic treatment. No pin tract infections,iatrogenic ulnar nerve injury,compartment syndrome,and complications such as Volkmann ischemic contracture occurred.
Conclusion:Closed reduction and percutaneous Kirschner wire fixation had advantages of exact reduction,firm fixation,fewer complications,less pain in children undergoing emergency surgery,and high success rate,so it is a safe and efficient treatment for humeral supracondylar fracture in children. |
| KEY WORDS Humeral fractures Child Fracture fixation,internal Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 范江荣,许益文,郑勇,游景扬.急诊闭合复位经皮克氏针内固定治疗Gartland Ⅱ-Ⅲ型儿童肱骨髁上骨折[J].中国骨伤,2015,28(5):464~467 |
| 英文格式: | FAN Jiang-rong,XU Yi-wen,ZHENG Yong,YOU Jing-yang.Emergency closed reduction and percutaneous Kirschner wire fixation for treatment of Gartland type Ⅱ-Ⅲ supracondylar fractures of the humerus in children[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(5):464~467 |
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