| 闭合复位治疗儿童Gartland Ⅱ型和Ⅲ型肱骨髁上骨折 |
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投稿时间：2012-10-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 吴立功 |
WU Li-gong |
太湖县人民医院骨科,安徽 太湖 246410 |
Department of Orthopaedics,the People's Hospital of Taihu,Taihu 246410,Anhui,China |
ysb4038@sina.com |
| 杨世斌 |
YANG Shi-bin |
太湖县人民医院骨科,安徽 太湖 246410 |
Department of Orthopaedics,the People's Hospital of Taihu,Taihu 246410,Anhui,China |
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| 期刊信息：《中国骨伤》2013年，第26卷，第2期，第98-101页 |
| DOI：10.3969/j.issn.1003-0034.2013.02.004 |
| 基金项目: |
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中文摘要:
目的：探讨儿童Gartland Ⅱ型和Ⅲ型肱骨髁上骨折闭合复位及固定的治疗方法.
方法：自2004年1月至2011年12月收治儿童肱骨髁上骨折110例,男 76例,女34例;年龄2～13岁,平均7岁;伸直型98例,屈曲型12例;GartlandⅡ型32例,GartlandⅢ型78例;伴有远折端旋转移位37例.分别在血肿内、臂丛及氯胺酮麻醉下,握持患肢的上臂及前臂对抗牵引,牵引数分钟后行手法闭合复位,经C形臂X线透视示骨折复位满意后用石膏托固定,对不稳定性骨折复位后经皮桡侧穿入1～2枚克氏针内固定再加石膏外固定.术后3～4周摄X线片,拆除石膏并拔出克氏针,开始康复锻炼.
结果：110例均获随访,时间3～18个月,平均12个月,所有患儿获得骨性愈合,骨折愈合时间6～8周,平均6.9周.无一例出现肘内翻畸形、血管神经损伤或 Volkmann挛缩等并发症.按 Flynn标准评定疗效：优74例,良 26例,可 10例.
结论：采用闭合复位石膏托外固定并对不稳定性骨折经皮克氏针内固定加石膏托外固定治疗儿童Gartland Ⅱ型和Ⅲ型肱骨髁上骨折是一种操作简单、创伤小、疗效较好的方法. |
| 【关键词】肱骨骨折 骨折固定术 儿童 |
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| Closed reduction and fixation for the treatment of Gartland typeⅡand Ⅲ supracondylar fracture of humerus in children |
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ABSTRACT
Objective:To evaluate the feasibility and results of closed reduction and fixation for the treatment of Gartland type Ⅱand Ⅲ supracondylar fracture of humerus in children.
Methods:From January 2004 to December 2011,110 children with supracondylar fracture of humerus were treated. Among them,76 patients were boy and 34 patients were girl,ranging in age from 2 to 13 years old,averaged 7 years old. Ninety-eight patients were extension type and 12 patients were flexion type. There were 32 patients with fracture of Gartland type Ⅱ and 78 patients with fractures of Gartland type Ⅲ. Thirty-seven patients had distal rotational displacement. Under anesthesia,the upper arm and forearm of the affected limb were treated with contraction for several minutes. The patients were treated with closed manipulative reduction and plaster external fixation while the satisfactory reduction was confirmed by C-arm X-ray. After the reduction,1 to 2 Kirschner pins were used through the radial side of the skin and plaster external fixation was carried out. Radiographic examination was conducted within 3 to 4 weeks after surgery,and the plaster and Kirschner pins were then removed,accompanied by rehabilitation training of the patients.
Results:All the patients were followed up,and the duration ranged from 3 to 18 months,with a mean of 12 months. All fractures healed within 6 to 8 weeks and the average healing time was 6.9 weeks. No complications such as cubitus varus deformity,neurovascular injury or Volkmann's contracture occurred. According to Flynn evaluation criteria,74 patients got an excellent result,26 good and 10 fair.
Conclusion:Through carefully reading X-ray films,Gartland type Ⅱ and Ⅲ supracondylar fracture of the humerus in children can be treated with closed reduction,plaster external fixation combined with percutaneous pinning for unstable fracture,which is a simple,less-invasive and satisfactory treatment method. |
| KEY WORDS Humeral fractures Fracture fixation Child |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴立功,杨世斌.闭合复位治疗儿童Gartland Ⅱ型和Ⅲ型肱骨髁上骨折[J].中国骨伤,2013,26(2):98~101 |
| 英文格式: | WU Li-gong,YANG Shi-bin.Closed reduction and fixation for the treatment of Gartland typeⅡand Ⅲ supracondylar fracture of humerus in children[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(2):98~101 |
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