俯卧位结合克氏针经皮辅助复位治疗GartlandⅢ型肱骨髁上骨折的观察

Combination of percutaneous pinning and prone position for treatment of children with type Ⅲ supracondylar fractures

关键词:  肱骨髁上骨折  闭合复位  俯卧位  经皮克氏针

Key words:  supracondylar fractures of humerus  closed reduction  prone position  percutaneous pinning

摘要:

目的　探讨俯卧位结合肘后经皮克氏针辅助骨折复位治疗GartlandⅢ型小儿肱骨髁上骨折的效果。　方法　回顾2012年1月至2013年12月期间，在X线机透视下,采用俯卧位结合肘后经皮克氏针辅助复位的方法，治疗GartlandⅢ型小儿肱骨髁上骨折68例患者的临床资料，其中男30例，女38例，年龄2～11岁，左侧28例，右侧40例，68例均为GartlandⅢ型伸直型肱骨髁上骨折，无血管损伤，其中6例正中神经损伤，3例桡神经损伤，受伤后1～5 d内手术。　结果　68例患者均闭合复位，术后随访6～12个月，临床评价优秀率为95.6%,骨折愈合良好。　结论　俯卧位结合肘后克氏针辅助复位克氏针内固定治疗GartlandⅢ型小儿肱骨髁上骨折，是一种有效地、安全的、实用的好办法。

Abstract:

Objective To analyze the surgical effect by combination of percutaneous pinning and prone position for treatment of children with type Ⅲ of supracondylar fractures. Methods Totally 68 children with type Ⅲ supracondylar fracture or extension type supracondylar fracture were enrolled in the study from February 2012 to December 2013. The patients, including included 30 males and 38 females with an average age of 2-11 years old, were treated in our department by combination of percutaneous pinning and prone position under X-ray. All patients had type Ⅲ supracondylar fractures without vessels damage. Among them, 28 children had left upper limb fracture and 40 had right. Surgeries were performed during 1-5 days after fracture. 6 children had median nerve injury and 3 children had musculospiral nerve injury. Results The 68 children were treated by closed reduction with percutaneous pinning and were followed up for 6-12 months. The excellent rate in clinical assessment, which was assessed in healed bones, was 95.6%. Conclusion It is effective, safe and practical for children with type Ⅲ supracondylar fractures to receive percutaneous pinning in posterior elbow at prone position and under X-ray.