克氏针固定并皮下神经前置术治疗肱骨髁上骨折疗效分析

Surgical treatment with Kirschner wire and anterior subcutaneous transposition for the fracture of humeral medial epicondylic which canpanied with injury of ulnar nerve

目的探讨尺神经皮下前置术在治疗肱骨髁上并尺神经损伤的疗效。方法回顾分析2004～2007年收治的此类患者58例,获得随诊50例,分别行单纯克氏针固定和克氏针固定并尺神经皮下前置术,术后评估优良率,观察尺神经恢复疗效。结果单纯固定组优良率为65%,固定并神经前置组优良率为80%,两组疗效不存在显著差异。结论Ⅰ期行尺神经皮下前置能提高尺神经损伤的恢复率,中重度伴有尺神经损伤的患者神经前置远期恢复更佳;未行神经前置的病例,若后期出现迟发性尺神经炎,可再行探查并皮下前置。

Objective To discuss the effect of anterior subcutaneous transposition in treating the fracture of humeral epicondylus medialis with injury of ulnar nerve. Methods Fifty eight except eight cases with fracture of humeral medial epicondylic with injury of ulnar nerve from 2004 to 2007 had been reviewed. Each cases had been respectively treated with pure Kirschner wire fixation,fixation with anterior subcutaneous transposition,then analyzed the effect and rehabilitation of ulnar nerve. Results The fine rate of ulnar nerve rehabilitation in the pure fixed group and the subcutaneous group was respectively 65%,80%,the effect of two groups had no significant difference.Conclusion Anterior subcutaneous transposition can enhance the curative effect,the effect of the moderate,severe-staged patient with anterior subcutaneous transposition is better than that of pure fixed group. If patients without subcutaneous transposition have Cubital tunnel syndrome after treatment,they should be operated with subcutaneous transposition again.