GartlandⅢ肱骨髁上骨折术后肘关节功能评价4年随访报告

Evaluation of Elbow Joint Function after Open Reduction for Humeral Supracondylar Fracture(Gartland Ⅲ) in Follow-up 4 Years

目的：探讨Gartland Ⅲ肱骨髁上骨折术后肘关节屈伸功能的远期疗效及并发症。方法：对88例Gartland Ⅲ肱骨髁上骨折行肘后正中切口入路，直视下复位骨折并用2枚克氏针交叉固定，石膏固定3周。3周后开始行肘关节功能锻炼，根据术后不同时间采用主动运动、助动运动和持续被动运动相结合的方法恢复肘关节功能。结果：81例患儿获6个月～4年的随访，平均18个月，骨折全部愈合。采用李稔生肘关节疗效判断标准：优70例（86．42％），良9例（11．11％），可2例（2．47％），无差者。本组术后均无神经、血管损伤等并发症。结论：Gartland Ⅲ肱骨髁上骨折术后行早期系统的肘关节功能锻炼，可最大限度地恢复肘关节功能，降低肘内翻的发生率，远期疗效满意。

Objective： To study long - term outcomes in function of elbow flexion and extension after open reduction for Gartland Ⅲ supracondylar fractures in children and its complications. Methods： 88 patients with Gartland Ⅲ supracondylar fracture of humerus were treated by open reduction. The standard posterior approaches were chosen for the operation. Initiative functional training, helping functional training and continual passive functional training to elbow joint were performed at postoperative different time. Results： 81 patients were available at final follow- up. The average duration of follow- up was 18 months （range, 6 months to 4 years）. All fractures were healed. According to LI Ren - sheng＇ s criteria for clinical evaluation of elbow joint, the scores were excellent in 70 cases （86.42 % ）, fine in 9 （11.11% ）, acceptable in 2 （2.47 % ） and poor in 0 case. No infection or nerve and blood vessel damage oecured. Conclusion. After open reduction for Gartland Ⅲ supracondylar fracture of humerus, the early and systematically functional exercises can further improve the function of elbow in children. The long-term outcomes is satisfied.