前内侧入路手术治疗小儿肱骨髁上骨折

Anterior medial approach operation for treatment of supracondylar fracture of humreu s in children

目的：探讨“前内侧入路”手术治疗那些必须行切开复位的小儿肱骨髁上骨折的疗效和优点。方法：回顾性分析近6年24例小儿肱骨髁上骨折的手术病例，男16例，女8例，年龄6～11岁，平均8．5岁。术前常规化验、心电图、胸片、患肢肘关节正侧位片，全麻或臂丛麻醉，取肘关节前内侧L型切口，先探查修复肱动脉、正中神经，然后显露并复位肱骨髁上骨折，经皮交叉克氏针内固定，术后前臂中立位石膏外固定3周，拍片见骨痂后撤石膏、克氏针，肘关节功能锻炼。结果：24例患者切口均甲级愈合，骨折愈合良好，肘关节活动良好，21例肘关节屈伸达正常范围，1例较正常范围小10度，1例较正常范围小20度，1例轻度肘内翻。结论：对于手术治疗小儿肱骨髁上骨折，前内侧入路优于其它入路，值得推广。

Ob jective：To explore the ＂anterior medial approach＂operation therapeutic effect and advantages of those who must fractures underwent open reduction and pediatric supracondylar humerus .Methods ：A retrospective analysis of patients with fracture operation nearly 6 years 24 cases of pediatric supracondylar humerus , male 16 cases, female 8 cases, age 6-11 years old, average 8.5 years old. Preoperative routine test , ECG, chest X-ray, limb elbow side position piece , general anesthesia or brachial plexus anesthesia , took el-bow anterior medial type L incision , the first exploration of brachial artery , repair median nerve , and then to emerge and reset supracondylar fracture of the humerus, percutaneous K-wire fixation, postoperative forearm neutrality bits of plaster external fixation for 3 weeks, X-ray showed callus retreat gypsum , Kirschner wire, elbow joint function exercise .Results：24 cases of patients with incision were healed , the healing of the fracture was good , good elbow joint activities , 21 cases of elbow flexion and extension of the normal range , 1 cases with normal range of 10 degrees, 1 patients with normal range of 20 degree, 1 cases of mild cubitus varus .Conclusion the operation treatment of supracondylar fracture of humerus in children , the anteromedial approach was superior to other approaches , might worthy of promotion .