针锯闭合截骨治疗儿童肘内外翻畸形

Kirschner with saw treating the elbow valgus or varus deformity in children by closed osteotomy

目的设计一种微创治疗儿童肘内外翻的矫形方法。方法用自制的直径为1．5mm的克氏针锯闭合截骨治疗儿童肘内外翻畸形38例。观察术后骨愈合、肘部提携角改善、肘关节功能和并发症情况。结果38例患儿均获得6个月至3年的随访，截骨区均愈合良好，无血管、神经及骨骺损伤等并发症。肘部提携角恢复至8°～15°，平均13．5°，随访过程中，未见矫正角度的丢失，手术前后摄X线片比较肱骨外上髁突出均未增大，外观与健肘无差异。按照肘关节Cassebaum评分标准，肘关节功能达到优29例，良8例，可1例，优良率97．37％（37／38），疗效满意。结论克氏针锯闭合截骨创伤小，安全可靠，操作方便，经临床应用效果良好，是一种治疗儿童肘内外翻畸形较理想的方法。

Objective To design a micro-traumatic way that can correct the elbow valgus or varus deformity in children. Methods Thirty-eight cases were treated with the self-made Kirschner with saw,the diameter of 1.5 mm. To observe and analyse the clinical effect in the healing of the bone,the improvement of the carrying angle, the function of the elbow and the complications. Results All the patients were followed up 6 months to 3 years.The areas of the cut bone healed without injuries of nerve, vascular and epiphysis. The carrying angle recovered from 8° to 15° （mean 13.5° ）. During the follow-up, there were no lost of the carrying angle and no herniation of external condyle of humerus and no statistical difference in appearance. According to Cassebaum marking standard,there were 29 cases excellent,8 cases good, 1 case fair,with good rate of 97.37%（37/38）. Conclusions The new technique is micro-traumatic,safe and easy to operate. It is an ideal treating method and worthy of clinical application.