摘要
目的观察闭合复位结合外侧交叉克氏针张力带原理固定治疗内侧柱塌陷型儿童肱骨髁上骨折的临床效果。方法采用闭合复位外侧交叉克氏针张力带原理固定治疗38例内侧柱塌陷型肱骨髁上骨折患儿。观察手术时间、术中放射性暴露时间和术后肘关节Baumann角改善程度、骨折愈合、肘关节功能及并发症发生情况。结果手术时间10~20(14.53±3.17)min,放射线暴露时间0.5~1.0(0.68±0.17)min。术后Baumann角均恢复正常,改善程度为6°~20°(12.61°±3.91°)。患儿均获得随访,时间12~32(19.89±6.80)个月。骨折均愈合良好,愈合时间为4~6(4.95±0.65)周。未发生骨折再移位、克氏针松动、针道感染等并发症。患儿肘关节功能恢复良好,末次随访时肘关节功能Cassebaum评分:优29例,良5例,可4例,优良率89.47%。结论闭合复位结合外侧交叉克氏针张力带原理固定治疗内侧柱塌陷型儿童肱骨髁上骨折临床效果满意。
Objective To observe the clinical outcomes of closed reduction and lateral crossed Kirschner wire fixation for medial column collapsed type supracondylar humeral fracture in children.Methods The 38 children of medial column collapsed supracondylar humeral fracture were treated with closed reduction and fixed with lateral crossed Kirschner wire based on tension band theory.Surgical time period,intraoperative exposure time period to X-ray,and correction of Baumann angle,fracture healing,function of elbow and complications were observed.Results Surgical time period was 10~20(14.53±3.17)min,intraoperative exposure time of X ray was 0.5~1.0(0.68±0.17)min,postoperative Baumann angle were all normal,with correction of 6°~20°(12.61°±3.91°).Patients were followed up for 12~32(19.89±6.80)months.All cases achieved satisfactory fracture healing within 4~6(4.95±0.65)weeks.There was no case of internal fixation failure,loosening of Kirschner wire or infection of wire tract.Elbow function was satisfactory.At the last follow-up,modified Cassebaum scales suggested that there were 29 cases of excellent,5 good,4 fair,with rate of 89.47%for excellent and good elbow function.Conclusions Closed reduction and lateral crossed Kirschner wire fixation is a good treatment choice for medial column collapsed type supracondylar humeral fracture in children with satisfactory clinical outcomes.
作者
朱博
时国富
仝彦格
ZHU Bo;SHI Guo-fu;TONG Yan-ge(Dept of Pediatric Orthopaedics and Traumatology, Luoyang Orthopedic-Traumatological Hospital of Henan Province, Luoyang, Henan 471002, China)
出处
《临床骨科杂志》
2019年第6期720-723,共4页
Journal of Clinical Orthopaedics
关键词
闭合复位
克氏针
肱骨髁上骨折
儿童
closed reduction
Kirschner wire
supracondylar fracture of humerus
child
