经肘后肱三头肌腱内外侧入路治疗儿童肱骨髁上骨折的临床分析

OPERATIVE TREATMENT OF SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN USING BILATEROTRICIPITAL APPROACH

目的探讨经肘后肱三头肌腱内外侧入路治疗儿童肱骨髁上骨折的手术效果。方法对100例肱骨髁上骨折患儿经肘后肱三头肌腱内外侧入路行切开复位克氏针内固定术，术后早期功能锻炼。结果本组100例均获得随访，随访时间24～36个月，平均30个月。本组术后4～6周复查X线片示骨折均已愈合。所有病例末次随防时无肘部畸形，无血管神经损伤表现。肘关节功能参照Flynn标准进行评价，其中优76例，良21例，可3例，差0例，优良率97％。结论经肘后肱三头肌腱内外侧入路治疗儿童肱骨髁上骨折手术操作安全、简单，对局部组织损伤小，术后可以早期进行肘关节功能锻炼，值得临床推广应用。

Objective To explore the effect of the operative treatment of supracondylar fractures of the humerus in children using bilaterotricipital approach. Methods Totally 100 cases of supracondylar fractures of the humerus in children using bilaterotricipital approach were performed an open reduction and internal fixation, and then early postoperative functional exercise was carried out. Results All cases were followed up for 24 - 36 months, average 30 months. From 4 to 6 weeks after post - operation, X - ray images showed that all fractures healed. All cases of last follow- up were without elbow deformity, no nerve inju- ry. The elbow function was evaluated according to Flynn criteria, excellent was in 76 cases, good in 21 ca- ses, fair in 3 cases, poor in 0 case, the excellent and good rate was 98%. Conclusions Bilaterotricipital approach in treatment of supracondylar fractures of the humerus in children is safe, simple, small to local tissue injury, can undertake elbow joint function exercise early after post- operation, and worthy of clinical popularization and application.