严重型儿童肱骨髁上骨折132例临床分析

Severely Displaced Supracondylar Fracture of Humerus in Children:Clinical Analyses of 132 Children

目的探讨严重型儿童肱骨髁上骨折的手术指征、手术方式、术中和术后并发症的防治及其治疗效果。方法回顾性分析2005年3月—2008年5月我科收治的132例严重型(GartlandⅢ型)儿童肱骨髁上骨折患儿的治疗方式及治疗效果。结果患者随访时间1～4年,平均1.7年,按照肘关节功能评价Flynn标准进行评价,其中优91例,良17例,可21例,差3例。发生不同程度肘内翻11例。结论切开复位交叉克氏针内固定是治疗严重型儿童肱骨髁上骨折的有效手术方法。早期手术治疗、术中准确的解剖复位和牢固固定及术后早期正确的关节功能锻炼是提高治疗效果、防治并发症的重要措施。

Objective To discuss the surgical indications and methods, prevention and treatment of intraoperative or postoperative complications and their curative effects in children with severely displaced supracondylar fracture of humerus. Methods The treatment and curative effects were analyzed retrospectively in 132 children with severely displaced supracondylar fracture of humerus （ Gartland m type） admitted to our department from March 2005 to May 2008. Results The follow - up time was 1 - 4 years, averaging 1.7 years. According to Flynn Criteria of Elbow Functional Assessment, excellent effect was noted in 91 patients, good in 17, not bad in 21, bad in 3. Various cubitus varus occurred in 11. Conclusion Open reduction and cross K - wire fixation is an effective method to treat severe displaced supracondylar fracture of humerus in children. Early surgi- cal treatment, intraoperative anatomic reduction and fixation, postoperative joint function exercises are important measures to im- prove curative effects, prevent and treat complications.