肱三头肌两侧开窗入路治疗高原地区儿童肱骨髁上GartlandⅢ型骨折

Brachial Triceps Fenestration Approach in the Treatment of Plateau Humeral Supracondylar Fracture of Gartland Type Ⅲ

目的：探讨经肱三头肌两侧开窗入路手术治疗高原地区儿童肱骨髁上GartlandⅢ型骨折的疗效。方法：对15例儿童肱骨髁上GartlandⅢ型骨折采用肱三头肌两侧开窗入路切开复位克氏针内外交叉内固定。结果：随访3~12个月,肘关节功能恢复良好,按照Flynn’s评价标准评定：优11例,良3例,可1例。结论：肱三头肌两侧开窗入路治疗儿童肱骨髁上GartlandⅢ型骨折具有损伤少,保留了伸肘装置的完整,很好地暴露了骨折端及尺神经,有利于骨折端的复位和克氏针固定,有效地避免了医源性神经损伤,能早期进行关节功能锻炼,后期肘关节功能恢复好,值得推广。

Objective：To investigate the curative effect of the brachial triceps fenestration approach in the treatment of humeral supracondylar fracture of Gartland type Ⅲ.Method：15 cases of children humeral supracondylar fracture Gartland type Ⅲ by bilateral triceps window approach,open reduction and Kirschner wire internal and external and internal fixation with crossed.Result：Follow up for 3 to 12 months,the elbow joint function recovered well,according to the Flynn＇s evaluation criteria：excellent 11 cases,good in 3 cases,fair in 1 case.Conclusion：Triceps side window into the road for the treatment of humeral supracondylar fracture Gartland type Ⅲ with less damage,retained the extensor elbow device complete,well exposed end of the ulnar nerve and fracture,fracture to end the reduction and Kirschner wire fixation,effectively avoid iatrogenic nerve injury,early functional exercise and late elbow joint functional recovery is good,is worthy of promotion.