外侧分散克氏针联合外侧可吸收接骨螺钉治疗GartlandⅢ型斜行肱骨髁上骨折疗效分析

Treatment of Gartland typeⅢoblique supracondylar humeral fractures with lateral dispersible Kirschner wires combined with lateral absorbable screws

目的探讨外侧分散克氏针联合外侧可吸收接骨螺钉治疗GartlandⅢ型斜行肱骨髁上骨折疗效分析。方法选取2023年1~7月期间张家口市第二医院收治的GartlandⅢ型斜行肱骨髁上骨折儿童(X线冠状面提示骨折线呈内上斜向外下)30例作为研究对象,采用随机数字表法分为A、B组,每组15例。A组患者行常规交叉克氏针(外侧两根+内侧一根),B组患者行外侧分散克氏针(两根)+外侧可吸收接骨螺钉。对比2组患者手术时间、愈合时间、住院时间及并发症,采用Flynn临床功能评定术后第4、8、12周肘关节功能,就诊复查肘关节X线片。结果B组手术时间(29.03±6.85)min、愈合时间(32.52±7.48)d、住院时间(5.96±1.58)d均短于A组(33.85±5.21)min、(38.69±6.25)d、(7.36±1.46)d,差异有统计学意义(P<0.05)。B组并发症发生率为6.67%,A组为40.00%,差异有统计学意义(P<0.05)。B组患者第4、8、12周Flynn临床功能评定优良率60.00%、93.33%、100.00%,高于A组40.00%、60.00%、73.33%,差异有统计学意义(P<0.05)。结论与常规行交叉克氏针(外侧两根+内侧一根),外侧分散克氏针(两根)+外侧可吸收接骨螺钉有助于缩短手术时间,减少并发症,促进愈合,改善肘关节功能。

Objective To investigate the treatment effect of routine rows of crossed Kirschner wires(two lateral+one medial)versus lateral decentralized Kirschner wire(two pins)+lateral absorbable screws.Methods Thirty cases of Gartland III oblique supracondylar humerus fractures(X-ray coronal plane suggests that the fracture line is medially oblique to externally inferior)admitted to Zhangjiakou Second Hospital from January 2023 to July 2023 were enrolled,and they were randomized 1:1 conventional crossed Kirschner wire(lateral two+medial one,group A,n=15)or lateral decentralized Kirschner wire(two pins)+lateral resorbable bone screws(group B,n=15).The operation time,healing time,hospital stays and complications were compared between the two groups,and the elbow joint function was assessed by Flynn scores for clinical function evaluation at weeks 4,8 and 12 of the operation,and the elbow joint X-ray imaging was reviewed at the clinic.Results The operation time(29.03±6.85)min vs(33.85±5.21)min,healing time(32.52±7.48)d vs(38.69±6.25)d,and hospital stays(5.96±1.58)d vs(7.36±1.46)d in the group B were significantly shorter than those in group A(P<0.05).The incidence of complications was significantly lower in group B than that in group A(6.67%.vs 40.00%,P<0.05).The patients in group B had significantly higher excellent rates of Flynn scores for clinical function evaluation at weeks 4(60.00%vs 40.00%),8(93.33%vs 60.00%),and 12(100.00%vs 73.33%)than those in group A(P<0.05).Conclusion Compared with the conventional crossed Kirschner wires(two lateral+one medial),lateral decentralized Kirschner wires(two pins)+lateral absorbable screws can shorten the operation time,reduce the complications,promote healing,and improve the elbow joint function.