闭合复位经皮克氏针内固定治疗儿童肱骨髁上骨折的临床分析

Clinical Analysis of Closed Reduction and Percutaneous Kirschner Wire Internal Fixation for the Treatment of Supracondylar Fracture of Humerus in Children

目的对儿童肱骨髁上骨折患儿应用克氏针内固定治疗的临床疗效及安全性进行分析。方法择取该院2015年1月-2018年12月接收的肱骨髁上骨折患儿75例作为研究对象,按手术方法不同分为两组,对照组51例给予肘部内侧小切口切开复位克氏针内固定治疗,试验组24例进行闭合复位克氏针内固定术治疗;观察两组患儿手术情况、临床优良率、术后住院时间以及骨折愈合时间,并发症发生情况。结果试验组患儿肘关节活动功能恢复优良率为95.83%(23例),高于对照组的74.51%(38例)(χ^2=4.888,P<0.05);试验组患儿手术时间为(28.31±7.92)min,出血量为(1.52±0.33)mL,住院时间为(3.42±1.22)d,骨折愈合时间为(4.01±0.43)周,各项手术指标优于对照组(t=7.677、27.677、8.347、11.818,P<0.05);试验组未见显著并发症,对照组并发症发生率为15.69%(8例),数据差异有统计学意义(χ^2=4.214,P<0.05)。结论对儿童肱骨髁上骨折患儿应用克氏针内固定治疗,过程中应用闭合复位相较于切开复位治疗并发症较少,术后愈合快,肘关节功能改善明显,值得临床推广应用。

Objective To analyze the clinical efficacy and safety of Kirschner wire internal fixation in children with supracondylar fractures of the humerus.Methods Seventy-five children with supracondylar fractures of the humerus received from our hospital from January 2015 to December 2018 were enrolled in the study.They were divided into two groups according to different surgical methods.51 patients in the control group were given small incision in the elbow internal fixation with Kirschner wire and 24 patients in the experimental group underwent closed reduction and Kirschner wire internal fixation.The operation,clinical excellent rate,postoperative hospital stay,fracture healing time and complications were observed.Results The excellent and good rate of recovery of elbow joint function in the experimental group was 95.83%(23 cases),which was higher than 74.51%(38 cases)in the control group(χ^2=4.888,P<0.05).The operation time of the experimental group was(28.31±7.92)min,the amount of bleeding was(1.52±0.33)mL,the hospitalization time was(3.42±1.22)d,the fracture healing time was(4.01±0.43)weeks,and the surgical indexes were better than the control group(t=7.677,27.677,8.349,11.818,P<0.05);no significant complications were observed in the test group.The complication rate of the control group was 15.69%(8 cases).The difference was statistically significant(χ^2=4.214,P<0.05).Conclusion Kirschner wire internal fixation is applied in children with supracondylar fracture of the humerus.The application of closed reduction in the process is less complicated than open reduction.The postoperative healing is quick and the function of elbow joint is improved.It is worthy of clinical application.