尺神经沟置针治疗儿童GartlandⅢ型肱骨髁上骨折

Internal Fixation with Kirschner Wires in Sulcus for Ulnar Nerve in Treatment of Gartland Ⅲ Supracondylar Fracture of Humerus in Children

目的探讨尺神经沟置针与桡侧克氏针交叉固定治疗儿童GartlandⅢ型肱骨髁上骨折的可行性及疗效。方法1998～2004年采用该方法治疗儿童GartlandⅢ型肱骨髁上骨折46例,术后测量BA角(Baumann角),于1年时按JOA肘关节功能评价法行功能评价。结果术后BA角(72.5±3.5)°,随访1年总优良率98%,无肘内翻畸形,无继发尺神经损伤。结论该方法可有效防止骨折远端继发尺偏移位,维持BA角,防止其增大,有效地避免了肘内翻的发生。尺神经前置可有效地防止继发尺神经损伤。

Objective To investigate the feasibility and the curative effect of internal fixation with closed Kirsehner wires in the sulcus for ulnar nerve and epicondylus lateralis of humerus in the treatment of Gartland Ⅲ supracondylar fracture of humerus in children. Methods Fortysix patients with Gartland Ⅲ supracondylar fracture of humerus in children were treated by fixing with closed Kirsehner wires in the sulcus for ulnar nerve and epicondylus lateralis of humerus since 1998. Baumann angle was measured after operation and the function was estimated according to JOA scoring for function of the elbow joint one year postoperatively. Results The Baumann angle was （72.5 ± 3.5）° after operation. The excellent and good result was 98% after one year. All patients were followed up for more than one year without cubitus varus and secondary injury of ulnar nerve. Conclusion The treatment of Gartland m supraeondylar fracture of humerus in children by internal fixation with closed Kirschner wires in the sulcus for ulnar nerve and epicondylus lateralis of humerus can effectively prevent secondary displacement of distal end of fracture, maintain Baumann angle and avoid cubitus varus, Anterior transposition of the ulnar nerve may be helpful to reduce the incidence of secondary injury of ulnar nerve.