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采用内侧入路对儿童肱骨髁上广泛移位骨折进行延迟切开复位及克氏针固定

Delayed Open Reduction and K-Wire Fixation of Widely Displaced Supracondylar Fractures of Humerus in Children using Medial Approach.

作者信息

Waikhom Sanjib, Mukherjee Sagnik, Ibomcha Irom, Digendra Akoijam, Sohkhlet Handboy R

机构信息

Associate Professor, Department of Orthopaedics, Regional Institute of Medical Sciences , Imphal, Manipur, India .

Post Graduate Trainee, Department of Orthopaedics, Regional Institute of Medical Sciences , Imphal, Manipur, India .

出版信息

J Clin Diagn Res. 2016 Aug;10(8):RC06-10. doi: 10.7860/JCDR/2016/20753.8349. Epub 2016 Aug 1.

Abstract

INTRODUCTION

Supracondylar fractures of humerus in children are usually treated with percutaneous pinning on emergency basis. When the operating time is delayed, percutaneous pinning is difficult due to massive swelling. Late presentation is common in developing countries.

AIM

To assess the outcome of open reduction and internal fixation with K-wire of widely displaced supracondylar fracture when operated later than 2 days after the injury.

MATERIALS AND METHODS

A total of 52 children (aged 3-12 years) with widely displaced supracondylar fracture of humerus (Gartland type-III) who presented later than 2 days after injury were treated with open reduction through medial approach and fixation with cross K-wires. RESULTs were assessed with Flynn's criteria.

RESULT

A total of 40 patients completed follow-up. Mean age of all (n=52) patients was 4.8 years (range 3-12 years). Mean delay of presentation was 7.5 days (range 2-14 days). Hundred percent patients had satisfactory results according to Flynn's criteria. Two patients had pin infections.

CONCLUSION

Open reduction through medial approach and fixation with two cross K-wires is a reliable method of treatment for supracondylar fractures of humerus in children when the operation is delayed.

摘要

引言

儿童肱骨髁上骨折通常在急诊情况下采用经皮穿针治疗。当手术时间延迟时,由于肿胀严重,经皮穿针会变得困难。在发展中国家,延迟就诊很常见。

目的

评估在受伤2天后进行手术时,采用克氏针切开复位内固定治疗广泛移位的肱骨髁上骨折的效果。

材料与方法

共有52例(年龄3至12岁)受伤2天后就诊的肱骨髁上广泛移位骨折(Gartland III型)儿童,通过内侧入路进行切开复位,并用交叉克氏针固定。根据弗林标准评估结果。

结果

共有40例患者完成随访。所有(n = 52)患者的平均年龄为4.8岁(范围3至12岁)。平均就诊延迟时间为7.5天(范围2至14天)。根据弗林标准,100%的患者结果满意。2例患者出现针道感染。

结论

当手术延迟时,通过内侧入路切开复位并用两根交叉克氏针固定是治疗儿童肱骨髁上骨折的可靠方法。

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