摘要
目的探讨急诊肘外侧小切口结合C臂透视克氏针固定治疗儿童GartlandⅢ型肱骨髁上骨折的临床疗效。方法回顾性分析我院2009年10月~2013年9月收治的46例GartlandⅢ型肱骨髁上骨折患儿的临床资料,均急诊行肘外侧小切口有限切开C臂透视3枚克氏针内固定,术后石膏托外固定3周,拆除石膏后逐渐进行功能锻炼。结果本组46例患者手术时间平均45（35~68）min,术中出血量平均20（10~50）ml。术中无血管神经损伤,术后无手术切口感染,平均随访时间28（15~51）个月。所有患者骨折愈合,无肘内、外翻畸形及前臂肌缺血挛缩等发生。采用Flynn肘关节评分标准评定疗效：优38例,良4例,可3例,差1例,优良率为91.3%。结论急诊肘外侧小切口结合C臂透视克氏针固定治疗儿童GartlandⅢ型肱骨髁上骨折疗效肯定,复位满意,创伤较小,可早期功能锻炼,且减少并发症的发生。
Objective To explore the clinical effects on emergency surgery of internal fixation with Kirschner wires via small elbow lateral incision plus C-arm fluoroscopy for humeral supracondylar fracture with Gartland Ⅲ in children. Methods The clinical data of 46 children with humeral supracondylar fracture of Gartland Ⅲ from October 2009 to September 2013 were analyzed retrospectively. All cases were performed emergency surgery of internal fixation with Kirschner wires via small elbow lateral incision plus C-arm fluoroscopy. External fixation of plaster was carried out for 3 weeks,and functional exercise was started gradually after removing of plaster fixation. Results The operative time was 35 to 68 minutes with an average of 45 minutes,and the intro-operative blood loss was 10 to 50 ml with an average of 20 ml. No intra-operative injury of vascular nerve and post-operative infection were found. All the 46 cases were followed up for 15 to 51 months with an average of 28 months. All fractures were healing without complications as cubitus varus,cubitus valgus and muscle contracture of forearm due to ischemia. According to Flynn elbow performance score,the elbow function was revealed perfect in 38 cases,good in 4 cases,fair in 3 cases,poor in 1 case,and the fineness rate was 91. 3%. Conclusion The emergency surgery of internal fixation with Kirschner wires via small elbow lateral incision plus C-arm fluoroscopy is an effective treatment for humeral supracondylar fracture with GartlandⅢ in children with satisfactory reduction,mini-trauma,early function exercise and less complications.
出处
《中国现代手术学杂志》
2015年第3期213-215,共3页
Chinese Journal of Modern Operative Surgery
关键词
肱骨骨折
骨折固定术
内
克氏针
急诊
humeral fractures
fracture fixation
internal
Kirschner wire
emergency treatment
