Department of Orthopedic Surgery, Xiang'an Hospital of Xiamen university, Xiamen, 361000, China.
Curr Med Sci. 2021 Aug;41(4):777-781. doi: 10.1007/s11596-021-2396-0. Epub 2021 Aug 17.
Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow. The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.
From February 2015 to August 2019, 73 patients with Gartland's type II and III supracondylar fractures were treated with this modified method. Totally, 68 of all patients were followed up for 3-12 months (mean 8.25 months). The evaluation results included fracture nonunion, ulnar nerve injury, pin track infection, carrying angle and elbow joint Flynn score.
The results showed that bone union was observed in all children, one case had an iatrogenic ulnar nerve injury, and the symptoms were completely relieved in 4 months after removing of the medial-side pin. All children had no cubitus varus deformity and no pin track infection, and the rate of satisfactory results according to Flynn's criteria score was 100%.
The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction, the risk of iatrogenic ulnar nerve injury, and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
肱骨髁上骨折是儿童肘部最常见的骨折。本研究介绍了一种改良的手术方法治疗儿童肱骨髁上骨折。
2015 年 2 月至 2019 年 8 月,采用改良方法治疗 73 例 Gartland Ⅱ型和Ⅲ型肱骨髁上骨折患者。所有患者均获得随访,随访时间 3-12 个月,平均 8.25 个月。评估结果包括骨折不愈合、尺神经损伤、针道感染、提携角和肘关节 Flynn 评分。
所有患儿均骨性愈合,1 例发生医源性尺神经损伤,内固定针去除后 4 个月症状完全缓解。所有患儿均无肘内翻畸形,无针道感染,Flynn 标准评分优良率为 100%。
改良闭合复位克氏针内固定可有效降低切开复位率、医源性尺神经损伤风险及肘内翻畸形发生率,是治疗儿童肱骨髁上骨折的有效方法。