王林涛;董震;李伟;齐克飞;李友;齐鹏;

• 1:青岛市妇女儿童医院小儿骨科

摘要(Abstract)：

[目的]探讨闭合复位经皮克氏针内固定治疗儿童伸直尺偏型肱骨髁上骨折的临床疗效。[方法]选择本院2015年3月~2016年2月收治的86例伸直尺偏型肱骨髁上骨折患儿,均给予闭合复位经皮克氏针内固定。术后统计患儿手术总时间、术中出血量以及骨折愈合情况,术前、末次随访对疼痛视觉模拟评分(VAS)作出评价,术后采用Flynn肘功能评分标准评估关节功能恢复情况,并观察术后有无Volkmann挛缩、肘内翻、针孔感染、尺神经损伤等并发症发生。[结果]术后切口均一期愈合,1例患肢出现针孔感染,经过及时治疗感染治愈,术后随访1年,随访期内克氏针无松动。末次随访VAS评分为(2.04±0.93)分,明显低于术前的(5.30±2.27)分(P<0.05);根据Flynn肘功能评分标准,术后优80例(93.02%)、良4例(4.65%)、可2例(2.32%);治疗总体满意率96.51%(83/86)。[结论]闭合复位经皮克氏针内固定治疗儿童伸直尺偏型肱骨髁上骨折,固定可靠,骨折愈合快,临床效果好,对患儿伤害小,是治疗儿童肱骨髁上骨折的有效方法。

关键词(KeyWords)： 闭合复位;经皮克氏针内固定;儿童;肱骨髁上骨折

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王林涛;董震;李伟;齐克飞;李友;齐鹏;

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参考文献(References)：

• [1]廖世杰,赵劲民,丁晓飞.儿童肱骨髁上骨折的分型与治疗进展[J].中国矫形外科杂志,2012,20(8):714-716.
• [2]Sharma A,Walia JPS,Brar BS,et al.Early results of displaced supracondylar fractures of humerus in children treated by closed reduction and percutaneous pinning[J].Indian J Orthop,2015,49(5):53-68.
• [3]Hussain S.Open reduction and internal fixation of displaced supracondylar fractures of humerus with crossed K-wires via medial approach[J].Malaysian Orthop J,2014,8(2):29-34.
• [4]魏俊强,林静,金宇,等.俯卧位闭合复位经皮克氏针内固定治疗儿童移位肱骨髁上骨折[J].中国骨与关节损伤杂志,2016,31(1):55-57.
• [5]Lal K,Laghari M A,Bhutto I A,et al.Supracondylar fracture of humerus in children treated with closed reduction and percutaneous cross pinning vs.two lateral pinning[J].J Liaquat Univ Med Health Sci,2014,13(2):71-75.
• [6]丁磊.儿童肱骨髁上骨折闭合及开放复位内固定的治疗分析[J].中国临床研究,2014,27(10):1231-1233.
• [7]罗冬冬,张智勇,刘彩娥,等.急诊闭合复位外侧经皮穿针固定治疗儿童GartlandⅡ型及Ⅲ型肱骨髁上骨折[J].中国骨与关节损伤杂志,2014,29(7):723-724.
• [8]Fan JR,Xu YW,Zheng Y,et al.Emergency closed reduction and percutaneous Kirschner wire fixation for treatment of Gartland type II-III supracondylar fractures of the humerus in children[J].Chin J Orthop Traumatol,2015,28(5):464-467.
• [9]Peshin C,Dhamele J,Nagda T.Controversial issues in closed reduction and percutaneous pinning of supracondylar fractures of Humerus in children[J].2015,1:11-15.
• [10]Wang H,Zhang Y,Zhang L,et al.The clinical effect of close reduction and percutaneous internal fixation by kwires for supracondylar humerus fracture in children[J].Med J Communications,2014,4:1-7.
• [11]胡南.闭合复位经皮穿针内固定术与闭合复位外固定术治疗儿童GartlandⅢ型肱骨髁上骨折的疗效比较[J].中国中医急症,2014,23(9):1752-1754.
• [12]许益文,郑勇,白祥军,等.手法复位经皮克氏针固定治疗儿童肱骨髁上骨折的疗效观察[J].中国骨伤,2015,28(6):521-523.
• [13]胡健,李洪鹏,吴冰,等.儿童肱骨髁上骨折复位判断指标系统在克氏针内固定术中的综合应用[J].中国矫形外科杂志,2015,23(14):1322-1324.
• [14]Luo DD,Liu G,Zhang ZY,et al.Closed reduction and three Kirschner pin fixation at the radial side for the treatment of supracondylar fracture in children with Gartland type II and type III[J].Chin J Orthop Traumatol,2015,28(7):666-668.
• [15]Xu YW,Zheng Y,Bai XJ,et al.Manipulative reduction and percutaneous K-wires fixation for treatment of supracondylar fractures of the humerus in children[J].Chin J Orthop Traumatol,2015,28(6):521-523.