肘内侧有限切开克氏针内固定治疗GartlandⅢ型儿童肱骨髁上骨折

Treatment of Gartland type Ⅲ pediatric supracondylar humeral fractures with medial limited incision and crossed Kirschner wire fixation

目的观察肘内侧有限切开交叉克氏针内固定治疗GartlandⅢ型儿童肱骨髁上骨折的临床疗效。方法回顾性分析2009年10月-2014年10月采用该入路及内固定方式治疗的GartlandⅢ型儿童肱骨髁上骨折32例的骨折愈合及并发症发生情况。结果 32例中有30例获术后随访,随访时间为3~26个月,平均6个月。手术切口均Ⅰ期愈合,骨折愈合良好,愈合时间2~5个月,平均3.2个月。针道感染2例,肘内翻畸形1例,无医源性血管、神经损伤发生,无异位骨化、缺血性肌挛缩等并发症发生。肘关节功能按Flynn评价标准评定优良率为90%。结论肘内侧有限切开复位交叉克氏针内固定治疗GartlandⅢ型儿童肱骨髁上骨折具有创伤小、骨折固定牢靠、神经损伤风险低、切口隐蔽等优点,是治疗GartlandⅢ型儿童肱骨髁上骨折的一种可行的治疗方法。

Objective To observe the clinical effect of treating Gartland type Ⅲ pediatric supracondylar humeral fractures with medial limited incision and crossed Kirschner Wire fixation. Methods 32 children with Gartland type Ⅲ supracondylar humeral fractures were renewed, with treated treated by medial limited incision and crossed Kirschner wire fixation during October 2009 to October 2009. Fracture union condition and complication occurring rate were evaluated. Results 30 cases were followed up, the following-up period ranged from 3 to 26 months, with an average of 6 months. All the surgical incision were healed primarily. Redution of fracture was well, the time of fracture union ranged from 2 to 5 months, average of 3.2 months. 2 cases of Pin tract infection and 1 case of cubitus varus deformity were occurred. Neither iatrogenic vascular and nerve injury nor heterotopic ossification andvVolkmann contracture was presented. According to the Flynn criteria, the excellent and good rate was 90%. Conclusion Treating Gartland type Ⅲ pediatric supracondylar humeral fractures with medial limited incision and crossed Kirschner wire fixation had the advantages of less invasive, steady fixation, lower nerve injury risk and hidden incision, which is an ideal option.