肘前外侧入路切开复位治疗儿童严重型肱骨髁上骨折159例

Internal fixation with Kirschner wire by anterolateral approach for treating severe humeral supracondylar fracture in 159 children cases

目的探讨肘前外侧入路切开复位克氏针固定治疗儿童严重型肱骨髁上骨折的手术指征、手术方法、疗效影响因素以及术后并发症的防治。方法回顾性分析该院2007～2010年收治的159例严重型肱骨髁上骨折(GartlandⅢ型肱骨髁上骨折)患儿的手术治疗及术后恢复情况,并评价其疗效。结果所有患儿随访时间6个月至3年,平均2.8年。按Flynn标准对肘关节功能进行评价,优135例,良16例,可5例,差3例,优良率94.97%;肘内翻2例。结论肘前外侧入路切开复位克氏针内固定术具有显露充分、操作方便安全、易于探查和减压、术后并发症少等优点,选择恰当的手术时机、固定方式、早期进行功能锻炼是提高手术疗效、减少并发症发生的有效途径。

Objective To investigate the indication,methods,factors influencing outcomes and complications of internal fixation with Kirschner wire by the anterolateral approach for the treatment of severe humeral supracondylar fracture in children.Methods The procedure was applied to 159 children patients with humeral supracondylar fracture（Gartland type Ⅲ） treated in our hospital during 2007-2010.The therapeutic process and recovery status were retrospectively analyzed for evaluating its effects.Results All cases were followed up postoperatively for 6 months to 3 years,at an average of 2.8 years.According to the Flynn score system,135 cases were evaluated as excellent,16 cases as good,5 cases as fair and 3 cases as poor,with the excellent and good rate of 94.97%.2 cases were cubitus varus.Conclusion Internal fixation with Kirschner wire by the anterolateral approach is easy to fully expose,operate and decompress with less postoperative complications.Choosing proper time of operation,proper way of fixation,and taking faculty training early can reduce complications effectively.