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闭合复位经皮克氏针内固定联合石膏外固定治疗儿童肱骨髁上骨折

[Closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children].

作者信息

Yao Zhen, Lin Zhi-Jin, Cao Lie-Hu, Zhang Chun-Cai, Wang Pan-Feng, Liu Xin-Wei, Su Jia-Can

机构信息

Department of Orthopaedics, Changhai Hospital Affiliated to the Second Medical University of PLA, Shanghai, 200433, China.

出版信息

Zhongguo Gu Shang. 2011 Apr;24(4):336-8.

PMID:21604536
Abstract

OBJECTIVE

To investigate the therapeutic effects of closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children.

METHODS

From June 2007 to December 2008, 27 patients with Gartland III supracondylar fractures were treated with closed reduction and percutaneous Kirschner wire fixation combined with plaster support. Among the patients, 18 patients were male and 9 patients were female, ranging in age from 6 to 12 years,with an average of 8.1 years. Fifteen patients were extension type, 12 patients were buckling type; fourteen patients were ulnar deviation, 13 patients were radial deviation. The duration from injury to treatment ranged from 0.5 to 8 days, averaged 3.6 days.

RESULTS

Twenty-seven patients were followed up, and the duration ranged from 6 to 24 months, averaged 13.5 months. The healing time ranged from 4 to 6 weeks after surgery, with a mean of 4.5 weeks. Complications including implants loosening, fracture re-displacement, Volkmarm contraction, needle point or deep infection, ulnar nerve injury, myositis ossificans were found during follow-up. Two patients had postoperative elbow varus, but the varus angle was not more than 15 degree,which may be due to inappropriate functional exercise or early removal of external fixation. According to Flynn criteria, 19 patients got an excellent result, 5 good, 2 poor and 1 bad.

CONCLUSION

Closed reduction and percutaneous Kirschner wire fixation combined plaster support for the treatment of unstable supracondylar fractures in children has advantages including little trauma, reliable fixation, good elbow function and appearance.

摘要

目的

探讨闭合复位经皮克氏针内固定联合石膏外固定治疗儿童肱骨髁上骨折的疗效。

方法

选取2007年6月至2008年12月收治的27例GartlandⅢ型肱骨髁上骨折患儿,采用闭合复位经皮克氏针内固定联合石膏外固定治疗。其中男18例,女9例;年龄6~12岁,平均8.1岁。伸直型15例,屈曲型12例;尺偏型14例,桡偏型13例。受伤至手术时间0.5~8天,平均3.6天。

结果

27例均获随访,随访时间6~24个月,平均13.5个月。术后骨折愈合时间4~6周,平均4.5周。随访期间出现的并发症包括内固定松动、骨折再移位、Volkmarm挛缩、针孔或深部感染、尺神经损伤、骨化性肌炎等。2例术后出现肘内翻,内翻角度不超过15°,可能与功能锻炼不当或外固定拆除过早有关。按Flynn标准评定:优19例,良5例,可2例,差1例。

结论

闭合复位经皮克氏针内固定联合石膏外固定治疗儿童不稳定型肱骨髁上骨折具有创伤小、固定可靠、肘关节功能及外观良好等优点。

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