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有限切开复位交叉克氏针固定治疗儿童Ⅲ型肱骨髁上骨折
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作者Author单位UnitE-Mail
陆军 LU Jun 东南大学附属中大医院骨科,江苏南京210009 Department of O rthopaedics,the Affiliated Zhongda Hospi t al of Dongnan University,Nanjing 210009, Jiangsu,China  
吴小涛 WU Xiao-tao 东南大学附属中大医院骨科,江苏南京210009 Department of O rthopaedics,the Affiliated Zhongda Hospi t al of Dongnan University,Nanjing 210009, Jiangsu,China  
陈辉 CHEN Hui 东南大学附属中大医院骨科,江苏南京210009 Department of O rthopaedics,the Affiliated Zhongda Hospi t al of Dongnan University,Nanjing 210009, Jiangsu,China  
李永刚 LI Yong-gang 东南大学附属中大医院骨科,江苏南京210009 Department of O rthopaedics,the Affiliated Zhongda Hospi t al of Dongnan University,Nanjing 210009, Jiangsu,China  
卜星平 BU Xing-ping 东南大学附属中大医院骨科,江苏南京210009 Department of O rthopaedics,the Affiliated Zhongda Hospi t al of Dongnan University,Nanjing 210009, Jiangsu,China  
茅祖斌 MAO Zu-bin 东南大学附属中大医院骨科,江苏南京210009 Department of O rthopaedics,the Affiliated Zhongda Hospi t al of Dongnan University,Nanjing 210009, Jiangsu,China  
期刊信息:《中国骨伤》2005年18卷,第9期,第533-535页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:探讨采用有限切开复位交叉克氏针内固定术治疗儿童Ⅲ型肱骨髁上骨折的临床疗效。

方法:自2000年3月-2002年9月采用肘内外联合小切口(长2~4cm)切开复位交叉克氏针内固定术,治疗完全移位的儿童肱骨髁上骨折共17例,所有骨折均为闭合性伸直型骨折,无神经血管损伤。患者平均年龄6.5岁(4~12岁)。从肘关节的功能和外观两方面进行疗效评价。

结果:术后随访时间8~32个月,平均17.5个月。所有骨折均于术后3~5周达到临床愈合并拔除克氏针,治疗过程中未出现骨折再移位。术后无一例发生缺血性挛缩、尺神经损伤、肘内翻等并发症。按Flynn评分:优5例,良7例,一般5例,差0例。肘关节伸屈活动度的丢失是影响治疗结果的主要原因,但这种活动受限会随着时间的延长而有所改善。

结论:采取有限切开复位交叉克氏针内固定手术的方法治疗完全移位的儿童肱骨髁上骨折,手术创伤小,能够使骨折得到满意的复位和固定,有效避免了医源性尺神经损伤,并可以获得良好的肘关节外形和功能。
[关键词]:肱骨骨折  骨科手术方法  骨折固定术,内  儿童
 
Limited open reduction and crossed pin fixation for treatment of type Ⅲ supra condylar humerus fractures in children
Abstract:

Objective: To analyze the clinical effects of type Ⅲ supracondylar humerus fractures in children treated with limited open reduc tion and crossed pin fixation.

Methods: From March 2000 to September 2002,sevent ee n children with complete displaced supra condylar humer us fractures were treated with limited open reduction and crossed Kirschner wire fixation.All t he fractures were close straighten type f ractures without neural and vascular inj u ries.The mean age of the patients was 6.5 y ears old (range 4 to 12).The final outco m e of the treatment was based on the func tion and contour of each elbow.

Results: All patients were followed up with an av erage of 17.5 months(rang 8 to 32 months)after operation.All the Kirschn er wires were removed at 3 to 5 weeks after operation as soon as the fractures heal ed and no postoperative displacement was observed during the treatment.There were 5 excellent,7 good,5 fair and none poor accordin g to the criteria of Flynn and no patien t developed a Volkmann's contracture,iat rogenic ulnar nerve injury or cubitus va rus during follow up time.The resu lts were affected mostly by the lost motion range of the elbow which can be impro ved with time by reinforcement of functi onal training.

Conclusion: This kind of treatment for children's ty pe Ⅲ supracondylar humerus fractures has advantages in little wound,satisfactory reduction and fixation,avoiding iatroge nic ulnar nerve injury and achieving goo d function and contour of the elbow.
KEYWORDS:Humeral fractures  Orthopaedics operative methods  Fracture fixation,internal  Child
 
引用本文,请按以下格式著录参考文献:
中文格式:陆军,吴小涛,陈辉,李永刚,卜星平,茅祖斌.有限切开复位交叉克氏针固定治疗儿童Ⅲ型肱骨髁上骨折[J].中国骨伤,2005,18(9):533~535
英文格式:LU Jun,WU Xiao-tao,CHEN Hui,LI Yong-gang,BU Xing-ping,MAO Zu-bin.Limited open reduction and crossed pin fixation for treatment of type Ⅲ supra condylar humerus fractures in children[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(9):533~535
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