不同固定方式对儿童不可复性肱骨髁上骨折疗效比较

CLINICAL EFFECT OF DIFFERENT FIXATION METHODS IN CHILDREN WITH IRREDUCIBLE SUPRACONDYLAR FRACTURE OF THE HUMERUS:A COMPARATIVE ANALYSIS

目的探讨有限切开复位克氏针经皮内固定与闭合复位外固定支架外固定治疗儿童不可复性肱骨髁上骨折的效果。方法选择2012年1月—2016年3月在我院接受治疗的CartlandⅢ型肱骨髁上骨折病儿62例,按照随机数字表法分为观察组(n=32)和对照组(n=30)。观察组应用有限切开复位克氏针经皮内固定治疗,对照组采取闭合复位外固定支架外固定治疗。术后随访1年,比较两组病儿的一般情况、末次随访肘关节优良率及术后不良反应。结果观察组手术时间、骨折愈合时间显著短于对照组(t=3.432、5.509,P<0.05);两组住院时间比较差异无显著性(P>0.05));观察组末次随访肘关节优良率显著高于对照组(χ2=5.984,P<0.05);两组术后并发症情况比较差异无显著性(P>0.05)。结论与闭合复位外固定支架外固定治疗比较,有限切开复位克氏针经皮内固定治疗不可复性肱骨髁上骨折愈合时间短,肘关节功能恢复效果更佳,值得临床推广。

Objective To investigate the clinical effect of limited open reduction and Kirschner wire transdermal internal fixation versus closed reduction and external fixation with an external fixator in the treatment of children with irreducible supracondylar fracture of the humerus.Methods A total of 62 children with Cartland type Ⅲ supracondylar fracture of the humerus who were hospitalized and treated in our hospital from January 2012 to March 2016 were enrolled and divided into observation group with 32 children and control group with30children using a random number table.The children in the observation group underwent limited open reduction and Kirschner wire transdermal internal fixation,and those in the control group underwent closed reduction and external fixation with an external fixator.The children were followed up for1year after surgery,and the two groups were compared in terms of general status,excellent and good rate of the elbow joint at the last follow-up,and postoperative adverse reactions.Results Compared with the control group,the observation group had significantly shorter time of operation and fracture healing time(t=3.432and5.509,P<0.05).There was no significant difference in the length of hospital stay between the two groups(t=0.372,P>0.05).At the last follow-up,the observation group had a significantly higher excellent and good rate of the elbow joint than the control group(χ^2=5.984,P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).ConclusionIn children with irreducible supracondylar fracture of the humerus,limited open reduction and Kirschner wire transdermal internal fixation has a shorter fracture healing time and a better clinical effect on the recovery of elbow function than closed reduction and external fixation with an external fixator,and therefore,it holds promise for clinical application.