39例少年肱骨髁上骨折的手术治疗

Surgical treatment of adolescent humeral supracondylar fracture in 39 cases

目的探讨采用切开复位交叉克氏针固定法与切开复位双接骨板固定法治疗移位型少年肱骨髁上骨折的手术治疗情况及临床疗效。方法自2006年5月至2010年3月,江苏省海安县中医院手术治疗移位型少年肱骨髁上骨折39例,其中,21例采用切开复位交叉克氏针固定(克氏针组),18例采用切开复位双接骨板固定(双接骨板组)。对两组手术治疗情况即手术时间、出血量、切口长度、骨折愈合时间进行比较;按照Flynn标准和HSS标准于术后12个月时对所有患者的肘关节功能进行评价比较。结果两组在手术时间、出血量、切口长度、骨折愈合时间方面比较,差异无统计学意义(P>0.05);按照Flynn标准和HSS标准,两组术后12个月时患侧肘关节功能优良率比较,双接骨板组优于克氏针组,差异有统计学意义(P<0.05)。结论对于移位型少年肱骨髁上骨折,切开复位双接骨板固定法是较佳的方法。

Objective To investigate the surgical therapy and clinical efficacy for adolescent displacement humeral supracondylar fracture by open reduction and internal fixation with dual plating and crossing Kirschner wire.Methods From May 2006 to March 2010,39 cases of adolescent displacement humeral supracondylar fracture in this hospital were treated by operation.Among them,21 cases were treated with crossing Kirschner wire（Kirschner wire group） and 18 cases were treated with dual plating（dual plating group）.The operation time,bleeding amount,incision length and fracture healing time were compared between the two groups.The elbow joint function in all cases were measured and compared by the Flynn standard and HSS standard in postoperative 12 months.Results Difference in the operation time,bleeding amount,incision length and fracture healing time between the two groups had no statistical significance（P0.05）.According to the Flynn standard and HSS standard,there was statistical difference in the excellent and good rate of the ipsilateral elbow joint function between the two groups（P0.05）.The dual plating group was better than the crossing Kirschner wire group with statistical difference between them.Conclusion For adolescent displacement humeral supracondylar fracture,open reduction and internal fixation with dual plating is a better choice.