闭合复位桡侧平行克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折

Closed reduction and radial parallel Kirschner wire internal fixation for the treatment of GartlandⅢsupracondylar fracture of humerus in children

目的:探讨闭合复位桡侧平行克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折的临床疗效。方法:自2015年5月至2019年10月,采用闭合复位桡侧平行克氏针固定法治疗72例GartlandⅢ型儿童伸直型肱骨髁上骨折患儿,其中男52例,女20例;年龄3~10(5.4±1.3)岁;GartlandⅢA型39例,GartlandⅢB型33例。观察患儿的手术时间、骨折临床愈合时间及功能锻炼时间,并采用Flynn肘关节评定标准进行临床疗效评价。结果:72例患儿均获得随访,时间2~6(3.5±1.4)个月。手术时间25~90(37.8±10.4)min,骨折临床愈合时间28~45(38.8±9.4)d,功能锻炼时间22~60(36.9±11.2)d。术后未出现肘内外翻畸形、医源性神经血管损伤、复位丢失、骨筋膜室综合征、感染等并发症。采用Flynn肘关节评定标准评估疗效:优60例,良10例,可2例。结论:采用闭合复位桡侧平行克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折具有微创治疗,固定可靠,手术时间短,内固定物取出简单,并发症少等优势。

Objective:To investigate clinical effect of closed reduction and radial parallel Kirschner wire internal fixation in treating GartlandⅢsupracondylar fracture of humerus in children.Methods:From May 2015 to October 2019,72 children with GartlandⅢsupracondylar fracture of humerus were treated by closed reduction and radial parallel Kirschner wire internal fixation,including 52 males and 20 females,aged from 3 to 10 years old with an average of(5.4±1.3)years old;39 patients classified to GartlandⅢA and 33 patients classified to GartlandⅢB.Operation time,fracture healing time,and functional exercise time were observed,Flynn elbow joint function score was used to evaluate clinical effects.Results:All patients were followed up from 2 to 6 months with an average of(3.5±1.4)months.Operation time was 25~90(37.8±10.4)min,fracture healing time was 28~45(38.8±9.4)days,functional exercise time was 22~60(36.9±11.2)days.No cubitus varus,iatrogenic neurovascular injury,reduction loss,compartment syndrome,infection or other complications occurred.According to Flynn elbow joint function score,60 patients got excellent results,10 good and 2 fair.Conclusion:Closed reduction and radial parallel Kirschner wire internal fixation in treating GartlandⅢsupracondylar fracture of humerus in children has advantages of minimally invasive,stable fixation,shorter operation time,easy to remove internal fixation,and less complications.