闭合复位克氏针固定治疗小儿肱骨髁上骨折38例
摘要
目的:评价闭合复位克氏针固定治疗加兰Ⅱ,Ⅲ型GAJF小儿肱骨髁上骨折的临床疗效。方法:选取浙江荣军医院2017年6月至2018年5月收治的38例肱骨髁上骨折加兰Ⅱ,Ⅲ型患儿,均采用闭合复位克氏针固定,闭合复位后骨折线方向与肘关节水平线向桡侧成锐角时,采用单桡侧克氏针固定,成钝角或平角时采用双侧克氏针交叉固定。结果:38例患儿均获随访,无医源性神经、血管损伤,无骨折不愈合,无骨骺损伤,末次随访Flynn肘关节功能评定结果,优32例,良4例,一般2例。结论:对于加兰Ⅱ,Ⅲ型小儿肱骨髁上骨折闭合复位后骨折线方向与肘关节水平线向桡侧成锐角时,采用单桡侧克氏针固定,成钝角或平角采用双侧克氏针交叉固定,患儿骨折愈合良好,提携角丢失减少,肘关节功能恢复正常,医源性尺神经损伤发生率显著减少,值得临床推广。
引文
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[4] 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.
[5] LEE B J,LEE S R,KIM S T,et al.Radiographic outcomes after treatment of pediatrie supracondylar humerus fractures using a treatment based classification system[J].J Orthop Trauma,2011,25(1):18-25.
[6] OMID R,CHOI P D,SKAGGS D L.Supracondylar humeral fractures in children[J].J Bone Joint Surg Am,2008,90(5):1121-1132.
[7] 黄淑明.闭合复位经皮固定治疗肱骨髁上骨折的进展[J].中国矫形外科杂志,2009,17(16):1234-1237.
[8] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版,北京:人民军医出版社,2011:539.
[9] GASTON R G.Medial and lateral pin versus lateral-entry pin fixation for type 3 supracondylar fractures in children:a prospective,surgeonrandomized study[J].J Pediatr Orthop,2010,30(8):799-806.
[10] TRIPURANENI K R,BOSCH P P,SCHWEND R M,et al.Prospective,surgeonrandomized evaluation of crossed pins versus lateral pins for unstable supracondylar humerus fractures in children[J].J Pediatr Orthop B,2009,18(2):93-98.
[2] 王亦璁,姜保国.骨与关节损伤[M].5版,北京:人民卫生出版社,2011:795.
[3] 罗冬冬,刘刚,张智勇,等.闭合复位桡侧3枚克氏针固定治疗幼儿GartlandⅡ型及Ⅲ型肱骨髁上骨折[J].中国骨伤,2015,28(7):666-668.
[4] 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.
[5] LEE B J,LEE S R,KIM S T,et al.Radiographic outcomes after treatment of pediatrie supracondylar humerus fractures using a treatment based classification system[J].J Orthop Trauma,2011,25(1):18-25.
[6] OMID R,CHOI P D,SKAGGS D L.Supracondylar humeral fractures in children[J].J Bone Joint Surg Am,2008,90(5):1121-1132.
[7] 黄淑明.闭合复位经皮固定治疗肱骨髁上骨折的进展[J].中国矫形外科杂志,2009,17(16):1234-1237.
[8] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版,北京:人民军医出版社,2011:539.
[9] GASTON R G.Medial and lateral pin versus lateral-entry pin fixation for type 3 supracondylar fractures in children:a prospective,surgeonrandomized study[J].J Pediatr Orthop,2010,30(8):799-806.
[10] TRIPURANENI K R,BOSCH P P,SCHWEND R M,et al.Prospective,surgeonrandomized evaluation of crossed pins versus lateral pins for unstable supracondylar humerus fractures in children[J].J Pediatr Orthop B,2009,18(2):93-98.