摘要
目的探讨难复位性肱骨髁上骨折的临床特点及外科治疗策略。方法回顾性分析2009年6月至2013年6月我们收治的24例经手术治疗的难复位性肱骨髁上骨折患儿临床资料。骨折均为伸直型损伤，其中年龄超过7岁者18例，占75％；伴发神经血管损伤16例，占67％。采取切开复位完成固定14例，有限切开手指引导复位克氏针固定6例，4例通过术中变换体位，经肘后侧穿入克氏针撬拨复位交叉克氏针固定。结果24例均顺利完成手术，患儿恢复正常肘关节功能，未发生前臂骨筋膜室综合征、肘内翻等并发症，合并神经损伤患儿均在术后短期内恢复。术后肘关节功能评分采用Flynn功能评分，优20例，良4例。结论对难复位性肱骨髁上骨折建议行切开复位或撬拨复位手术治疗，可取得满意疗效，且不增加手术并发症。
Objetive Retrospective analysis of chnical characteristics and surgical treatment strategy of hard reset type of supracondylar fracture of humerus. Methods In 155 cases of supracondylar fracture of the humerus under operative treatment from June 2009 to June 2013 ,in which 132 cases received closed reduction of Kirschner pin fixation and 24 cases from them can not reach the satisfactory reduction level or displace again after the dosed reduction over three times. In 24 cases there are 14 cases fixed by open reduction,6 cases fixed by Kirschner pin fixation which was leaded by finger through limited incision ,4 cases fixed by the crossed Kir- schner pin fixation which was by poking reduction with Kirschner pin penetrating through back of the elbow,position changing during the operation. Analyzing the damage mechanism, imaging manifestations, produced damage condition, characteristics of fracture line, ages of sick children etc,we summarized the characteristics. Analyzing the treatment methods, we raised the treatment strategy of this type of fracture. Results Among the 24 cases who are extension type damage succeed in the surgery,18 cases over7 years old occupy 75 percent and 16 cases with neurovascular injury occupy 67 percent. None of the cases received various treatment methods lead to cubitus varus or forearm osteofascial compartment syndrome. There were 20 cases in excellent and 4 cases in good ranked by the Flynn function grade,evaluating the function of elbow joint. Conclusions The hard reset type of supracondylar fracture of humerus primarily happen to advanced children, and are muhipled in high-energy injury which is the Gartland type 111, extension type damage and tracks acrossing the fossa intercondyloidea in inclined direction. This type of fractue is always accompanied with neurovascular injury. The open reduction and poking reduction can not increase the recent complications of surgery.
出处
《临床小儿外科杂志》
CAS
2015年第6期531-533,共3页
Journal of Clinical Pediatric Surgery
关键词
肱骨骨折
外科手术
治疗结果
儿童
Humeral Fractures
Surgical Procedures, Operative
Treatment Outcome
Child
作者简介
E-mail：2013455423@qq．com
通讯作者：赵景新
