前侧入路对儿童Gartland Ⅲ 型肱骨髁上骨折的治疗效果

Efficacy of anterior and lateral approaches on extension-type supracondylar hume rus fractures in children

目的 探讨经前侧入路切开复位克氏针内固定治疗儿童Gartland Ⅲ型肱骨髁上骨折的疗效.方法 对两种术式行回顾性分析,选取2004-2008年行外侧入路治疗Gartland Ⅲ型肱骨髁上骨折患儿38例为外侧组,2009-2012年行前侧入路治疗46例为前侧组,比较两组患者的治疗效果.结果 以Flynn标准评估疗效,外侧组中优19例（50.0%）,良18例（47.4%）,一般1例（2.6%）;前侧组中优31例（67.0%）,良15例（33.0%）;两组疗效比较差异未见统计学意义（P〉0.05）.外侧入组瘢痕形成2例,前方组未见明显瘢痕.结论 经前侧切开复位切口美观,便于暴露骨折位置,是治疗GartlandⅢ型肱骨髁上骨折有效方法.

Objective To investigate the effects of anterior approach versus lateral approach open reduction and Kirschner needle fixation on irreducible Gartland type Ⅲ supracondylar fractures of the humerus in children.Methods Two kinds of operation were analyzed retrospectively, 38 children with supracondylar fracture of humerus in 2004-2008 were treated by lateral approach as lateral group,and 46 children from 2009 to 2012 were treated by anterior approach as anterior group.The efficacy of the two groups was compared.Results According to Flynn criteria, excellent in 19 cases（50.0%）, good in 18 cases（47.4%）, and fair in one case（2.6%） of the lateral group;excellent in 31 cases（67.0%）, good in 15 cases（33.0%） of the anterior group, the differences were not significant（P〉0.05）.Scarring in two cases of the lateral group, that had not seen of the anterior group.Conclusions Open reduction of anterior is beautiful, easy to expose the fracture position, treatment is Gartland type Ⅲ effective method on the humerus condyle fracture.