角式外固定架与克氏针治疗儿童肱骨髁上骨折疗效比较

Therapeutic effect of angular external fixator versus Kirschner wire on humeral supracondylar fracture in children

目的:对比研究角式外固定架与克氏针治疗儿童肱骨髁上骨折的疗效。方法:选取2013年3月至2016年3月在我院骨科住院的肱骨髁上骨折患儿共24例,分型均为GartlandⅢ型,随机分为外固定架组与克氏针组,均采用肘外后侧方入路术式。克氏针组采用交叉克氏针内固定,外固定架组给予角式外固定架固定。术后2组均常规配合支具外固定及功能锻炼,并做3个月随访,采用Flynn肘关节评分法评定2组疗效。结果:克氏针组优良率41.67%,外固定架组优良率58.33%,2组比较有显著性差异(P<0.05)。结论:角式外固定架治疗肱骨髁上骨折较传统交叉克氏针内固定疗效更优,具有临床推广价值。

Objective： To compare the therapeutic effect of angular external fixator and Kirschner wire fixation on humeral supracondylar fracture in children. Methods： From March 2013 to March 2016,24 children with Gartland Ⅲ type of humeral supracondylar fracture admitted to our Department of Orthopedics were randomly divided into external fixator group and Kirschner wire group,and both groups were treated via posterolateral elbow approach. Internal fixation with crossed Kirschner wire was applied in Kirschner wire group while angular external fixator was applied in external fixator group. Children in both groups received routine external fixation and performed functional exercise after operation,and they were followed up for3 months. The therapeutic effects of the two groups were evaluated by Flynn elbow scoring method. Results： The excellent and good rate of Kirschner wire group was 41. 67%,and that of external fixator group was 58. 33%,the difference between the two groups was statistically significant（ P〈0. 05）. Conclusion： Angular external fixator has better curative effect in the treatment of humeral supracondylar fracture in children than traditional internal fixation with crossed Kirschner wire. It is worthy of clinical promotion.