【摘要】 背景:交叉克氏针内固定是目前治疗儿童GartlandⅢ型肱骨髁上骨折的首选方法,但仍未从根本上解决并发症发生问题。目的目的:评价尺神经沟置针术式治疗儿童GartlandⅢ型肱骨髁上骨折的可行性及疗效。方法方法:1998年1月到2010年10月采用尺神经沟置针术式治疗儿童GartlandⅢ型肱骨髁上骨折患儿144例,随访时检查环小指运动及感觉情况,测量双上肢长度、肘关节活动度,摄双肘正位片测量Baumann角或提携角。采用HSS肘关节功能评价法评分标准进行肘关节功能评定。结果结果:144例患儿,随访14~85个月,平均60个月,根据HSS肘关节功能评定法行功能评价:优140例,良4例,无肘内翻和肘外翻畸形发生,无继发尺神经损伤,肢体无短缩。结论结论:尺神经沟置针术式治疗儿童GartlandⅢ型肱骨髁上骨折可获得良好的肘关节功能及外观,预防了肘内翻畸形及继发尺神经损伤,且对骨骺生长发育无明显影响。更多还原

【Abstract】 Background: Internal fixation with closed Kirschner wires is the preferred treatment for Gartland Ⅲ supracondylar fracture of humerus in children in recent years. But complications still occurred after the surgery. Objective:Objective: To investigate the feasibility and curative effect of internal fixation with closed Kirschner wires in sulcus forulnar nerve and epicondylus lateralis of humerus in the treatment of Gartland Ⅲ supracondylar fracture of humerus in children. Methods:Methods: A total of 144 children with Gartland Ⅲ supracondylar fracture of humerus were treated with internal fixation with cross Kirschner wires in the sulcus for ulnar nerve and epicondylus lateralis of humerus between January 1998 and October 2010. The length of upper extremities,elbow joint range of motion,Baumann angle and carrying angle were measured. The function of elbow joint was estimated by HSS scoring. Results:Results: The follow-up period ranged from 14 to 85 months(mean: 60 months) in all the 144 patients. According to HSS score for elbow joint,excellent outcome achieved in 140 children and good results in 4 ones. No cubitus varus,cubitus valgus,secondary injury of ulnar nerve or extremity shortness were observed. Conclusions:Conclusions: Satisfactory appearance and elbow joint function can be obtained after internal fixation with Kirschner wires in the sulcus forulnar nerve and epicondylus lateralis of humerus for the treatment of Gartland Ⅲ supracondylar fracture of humerus in children. The treatment will not interfere with epiphyseal growth and can prevent from cubitus varus and secondary ulnar nerve injury.更多还原