有限切开复位克氏针内固定治疗儿童肱骨外髁骨折

Limited open reduction and Kirschner wire fixation for the treatment of fracture of lateral condyle of humerus in children

目的观察小切口有限切开复位克氏针内固定治疗儿童Ⅱ、Ⅲ型肱骨外髁骨折的疗效。方法2014年1月-2016年1月,应用小切口有限切开复位,克氏针内固定治疗儿童Ⅱ、Ⅲ型肱骨外髁骨折12例,均为闭合创伤性肱骨外髁骨折。术后屈肘90°,石膏托外固定3周,6周拔除克氏针。结果所有患者均获得随访,随访时间16~24个月,均达到骨性愈合,未发生骨筋膜室综合征、缺血性肌挛缩、肘外翻、神经损伤等并发症,肘关节功能恢复良好。Hardacre评分:优11例,良1例。结论急诊早期采用小切口有限切开复位克氏针内固定治疗儿童肱骨外髁Ⅱ、Ⅲ型骨折,可以减轻患儿骨折后的痛苦,利于早期恢复,是一种较好的治疗方法,其安全性和可靠性有良好的保证。

Objective To observe the effect of small incision limited open reduction and Kirschner wire internal fixation on the treatment of humeral lateral condyle fracture type Ⅱ and Ⅲ in children. Methods From January 2014 to January 2016, 12 cases of children with type Ⅱ and Ⅲ fractures of the lateral condyle of humerus were treated by limited open reduction, internal fixation with Kirschner wire. The average age was 5.5 years old. All of them had closed traumatic fracture of lateral condyle of humerus. After operation, the elbow had been flexted 90 degrees with plaster external fixation for 3 weeks, 6 weeks later, removed Kirschner wire. Results All the patients were followed up for 12~24 months, all of them achieved bony union. There were no complications such as compartment syndrome, ischemic contracture, cubitus valgus and nerve injury. Elbow joint function recovered well. The Hardacre score showed excellet in 11 cases, good in 1 case. Conclusion Small incision limited open reduction and internal fixation with Kirschner wire, as to the treament of humeral condy lar fracture in children with type Ⅰ and Ⅱ can reduce the pain of children after fracture and get the earlier recovery. It is a good method of treatment.