内侧入路克氏针内固定治疗儿童肱骨髁上骨折

Cross-pinning internal fixation for Gartland Ⅲ humerus supracondylar fractures via medial approach in children

目的评价肘内侧入路克氏针内固定治疗儿童GartlandⅢ型肱骨髁上骨折的临床疗效。方法采用肘内侧入路、克氏针内固定、石膏外固定治疗86例GartlandⅢ型肱骨髁上骨折患儿。结果 86例均获随访,时间5-36个月。骨折全部愈合。无一例发生内固定移位;2例于术后出现轻度肘内翻畸形。肘关节功能根据F lynn评价标准：优81例,良5例。3例合并神经损伤患者6个月康复。无Volkmann缺血性肌挛、骨化性肌炎、缺血性肌坏死等并发症。结论肘内侧入路交叉克氏针内固定创伤小、并发症少且内固定可靠,是治疗儿童肱骨髁上骨折安全有效的方法。

Objective To evaluate the effect of cross-pinning internal fixation for Gartland Ⅲ humerus supracondylar fractures via medial approach in children.Methods There were 86 children with Gartland Ⅲ supracondylar fractures were treated with cross-pinning internal fixation via medial approach and plaster immobilization.Results All patients got follow-up for at least 5 months（range 5~36 months）,and all fractures healed without internal fixation failure and 2 patients had slight cubitus varus.There were 81 patients got excellent results and 5 good according to Flynn′s criteria.The 3 patients with nerve injury recovered completely after 6 months.There was no Volkmann contracture,myositis ossificans or ischemic myonecrosis complications.Conclusions The treatment of cross-pinning internal fixation via medial approach is effective alternative for children supracondylar fractures with minimal trauma and good clinical data.