肘内侧入路3枚克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折

Fracture of medial elbow incision three Kirschner wire fixation for the treatment of Gartland Ⅲ supracondylar humeral

目的探讨肘内侧入路3枚克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折的临床疗效。方法选择2010年3月至2013年4月邯郸市第二医院收治的GartlandⅢ型儿童肱骨髁上骨折患儿109例,均采用肘内侧入路、3枚克氏针交叉固定治疗;依据Flynn功能评定标准进行疗效评价。结果 109例患儿均随访1～3 a,平均（2.1±0.7）a;骨折全部愈合,肘关节功能按照Flynn功能评定标准,优良率达98.2%。所有患儿无切口感染、内固定移位,术后无肘内翻畸形、骨化性肌炎及Volkmann肌挛缩等并发症。4例术前尺神经损伤患儿均在术后5个月内恢复。结论肘内侧入路3枚克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折具有直视下复位保护尺神经,骨折断端稳定性高,可早期功能锻炼,并发症少等优点,是治疗GartlandⅢ型儿童肱骨髁上骨折的有效方法。

Objective To explore the clinical curative effect of the fracture of medial elbow incision three Kirschner wires fixation for the treatment of Gartland type Ⅲ supracondylar humeral. Methods One hundred and nine children with Gartland Ⅲ supracondylar humeral were collected in the second hospital of Handan city from March 2010 to April 2013. All the patients were performed with the fracture of medial elbow incision three Kirschner wire fixation. The curative effect was estimated by the Flynn functional evaluation criteria. Results One hundred and nine cases were followed up for one to three years,mean（2.1 ±0.7）years.All fractures healed,the elbow joint function according to the standard Flynn function evaluation,the excellent and good rate was 98. 2%. Incision infection,fixation shift,cubitus varus deformity,myositis ossificans and Volkmann muscle contracture were not found in all the patients. Four cases with ulnar nerve injury before surgery healed five months after operation.Conclusion The fracture of medial elbow incision three Kirschner wire fixation for the treatment of Gartland Ⅲ supracondylar humeral has the advantage of protecting the ulnar nerve under euthyphoria,fracture of high stability,early functional exercise,less complications,which is an effective method for treatment of Gartland Ⅲ fractures of humeral supracondylar.