空心加压螺钉联合克氏针内固定治疗儿童陈旧性肱骨外髁骨折的临床疗效

The clinical observation of cannulated screw combined with Kirschner wire internal fixation in treatment of old humeral condyle fracture in children

目的探讨切开复位空心加压螺钉联合克氏针内固定治疗儿童陈旧性肱骨外髁骨折的临床疗效。方法收集2015年7月至2019年8月安徽省儿童医院收治的31例采用该手术方式治疗的陈旧性肱骨外髁骨折患儿临床资料,观察骨折愈合情况及并发症,记录术前、术后肘关节活动度及肘关节Dhillon评分评估手术效果。结果患儿术前患侧肘关节活动度平均(86.61±21.58)°,肘关节Dhillon评分平均(5.35±1.08)分;所有患儿术后4~7周均获得临床愈合,术后随访2~4年,平均(2.73±0.63)年;所有患儿术后均未出现严重并发症;术后随访2年肘关节活动度平均(128.84±8.88)°,Dhillon评分平均(8.61±0.50)分,肘关节功能优良率为100.00%。术后2年肘关节活动度及肘关节Dhillon评分较术前差异均有统计学意义(P<0.001)。结论切开复位空心加压螺钉联合克氏针内固定治疗儿童陈旧性肱骨外髁骨折疗效确切,并发症少。

Objective To investigate the clinical effect of open reduction and cannulated screw combined with Kirschner wire internal fixation in the treatment of children with old lateral condyle fracture of humerus.Methods The clinical data of 31 children with old lateral condyle fracture of humerus treated by this surgical method in Anhui Children’s Hospital from July 2015 to August 2019 were retrospectively collected,and fracture healing and complications were observed.Elbow range of motion and elbow Dhillon score were recorded before and after surgery to evaluate the surgical effect.Results The average range of motion of the affected elbow was(86.61±21.58)°and Dhillon score was(5.35±1.08).Clinical healing was achieved in all patients 4~7 weeks after surgery,and follow-up was 2~4 years,with an average of(2.73±0.63)years.None of the children had serious complications after surgery.The mean range of motion of the elbow was(128.84±8.88)°and Dhillon score was(8.61±0.50).The excellent and good rate of elbow function was 100.00%.The range of motion and Dhillon score of the elbow two years after surgery were statistically different from those before surgery(P<0.001).Conclusion Open reduction of cannulated screw combined with Kirschner wire internal fixation in the treatment of children with old humeral lateral condyle fracture is effective with fewer complications.