肘内侧入路手术治疗儿童Gartland Ⅲ型肱骨髁上骨折

Open reduction through medial exposure for gartland Ⅲ supracondylar fractures of the humerus in children

目的:探讨肘内侧入路在手术治疗儿童Gartland Ⅲ型肱骨髁上骨折中的应用。方法:2003年1月～2008年9月,采用经肘内侧入路切开复位内外侧交叉克氏针固定方法治疗儿童伸直型Gartland Ⅲ型肱骨髁上骨折216例。随访采用Flynn临床功能评定标准,从肘关节的伸屈功能和外观两方面进行疗效评价。结果:术后随访1个月～2年4个月。按Flynn临床功能评定标准术后优良率达92.13%,疗效满意。结论:肘内侧入路切开复位内外侧交叉克氏针固定术治疗儿童GartlandⅢ型肱骨髁上骨折是一种安全有效的手术方法。切口瘢痕位于肘内侧,隐蔽性好,符合现代人对美观的要求。手术中对骨折解剖复位,尤其是对骨折远端尺偏、尺倾和内旋的矫正,可以有效减少肘内翻的发生。

Objective：To explore open reduction through medial exposure for Gartland Ⅲ supracondylar fractures of the humerus in children.Methods：216 cases with Gartland Ⅲ supracondylar fractures of the humerus received open reduction through media exposure plus crossed Kirschner wire internal fixation.Results：All cases were followed up for 1 month to two years and four months.According to Flynn criteria,the excellent and good rate was 92.13%.Conclusions：Open reduction through media exposure plus crossed Kirschner wire internal fixation is a safe and effective treatment for Gartland Ⅲ supracondylar fractures of the humerus in children.Incision scar is at the medial elbow and concealed.Correction of ulnar deviation,ulnar tilt and internal rotation can be effective in reducing the incidence of cubitus varus.