超声辅助下闭合复位克氏针固定治疗儿童肱骨髁上骨折

Ultrasonic Assisted Closed Reduction and Kirschner Wire Fixation for Supracondylar Fractures of the Humerus in Children

目的观察超声辅助下闭合复位克氏针固定治疗儿童肱骨髁上骨折的临床疗效。方法自2014年10月—2018年10月本院收治住院患者,临床诊断为肱骨髁上骨折,采用超声辅助下闭合复位克氏针固定治疗儿童肱骨髁上骨折,术后评估其临床疗效。结果本组48例患者均获得6~12月随访,平均随访时间8个月,所有患者伤口均Ⅰ期愈合,无感染及神经损伤症状,术后1个月、3个月、6个月复查肘关节X线片,见骨折均对位对线良好,固定坚强。48例患者骨折均获得愈合,愈合时间为10~24周,平均12.8周。均无断钉及骨折不愈合及创伤性关节炎等并发症发生,效果满意。结论采用超声辅助下闭合复位克氏针固定可准确显示骨折复位情况及尺神经位置,引导穿针,可有效避免尺神经损伤,提高穿针的安全性,临床效果满意。

Objective To observe the clinical effect of ultrasonic-assisted closed reduction and kirschner wire fixation on supracondylar fracture of humerus in children.Methods From October 2014 to October 2018,the patients admitted to the hospital was clinically diagnosed as supracondylar fracture of the humerus.Closed reduction and kirschner wire fixation assisted by ultrasound were used to treat supracondylar fracture of the humerus in children.Assess clinical effect after surgery.Results All 48 patients in this group were followed up for 6 to 12 months.The average follow-up time was 8 months.All patients healed in stageⅠwithout symptoms of infection and nerve damage.The elbow joint X-ray films were reviewed in 1 month,3 months,and 6 months after surgery.the fractures are well aligned and firmly fixed.Fracture healing was achieved in all 48 patients.The healing time was 10 to 24 weeks,with an average of 12.8 weeks.There were no complications such as broken nails,fracture nonunion,and traumatic arthritis,and the results were satisfactory.Conclusion Closed reduction and kirschner pin fixation assisted by ultrasound can accurately show the reduction of fracture and the position of ulnar nerve,guide the puncture,effectively avoid ulnar nerve injury,improve the safety of puncture,and achieve satisfactory clinical results.