【摘要】 目的 探讨闭合复位经皮交叉克氏针内固定治疗儿童GartlandⅢ型肱骨髁上骨折的疗效。方法 将68例GartlandⅢ型肱骨髁上骨折患儿根据手术方法不同分为对照组(34例，采用切开复位经皮交叉克氏针内固定治疗)和观察组(34例，采用闭合复位经皮交叉克氏针内固定治疗)。记录住院时间、骨折愈合时间、关节活动度及并发症发生情况，测量肘关节Baumann角和远端骨折块侧方及前后移位情况，采用肘关节功能Flynn评分评价疗效。结果 患儿均获得随访，时间6～24(11.3±6.7)个月。住院时间、骨折临床愈合时间及骨性愈合时间观察组均短于对照组(P<0.05)。两组术后Baumann角、远端骨折块侧方及前后移位情况、移位程度分级比较差异均无统计学意义(P > 0.05)。末次随访时肘关节功能疗效优良率、关节活动度观察组高(大)于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P > 0.05)。结论 闭合复位经皮交叉克氏针内固定治疗儿童GartlandⅢ型肱骨髁上骨折，能够有效缩短住院时间、骨折临床愈合时间及骨性愈合时间，并改善肘关节的功能。更多还原

【Abstract】 Objective To explore the efficacy of closed reduction and percutaneous crossed Kirschner wire internal fixation in the treatment of Gartland type Ⅲ supracondylar fracture of the humerus in children. Methods Sixty-eight children with Gartland type Ⅲ supracondylar fractures of the humerus were divided into the control group( The 34 cases were treated with open reduction and percutaneous crossed Kirschner wire internal fixation) and the observation group( The 34 cases were treated with closed reduction and percutaneous crossed Kirschner wire internal fixation),according to different surgical methods. The length of hospital stay,fracture healing time,elbow joint activity range and the occurrence of complications were recorded. The Baumann angle of the elbow joint,and the lateral and anteroposterior displacement of the distal fracture fragment were measured. The therapeutic effect was evaluated by the Flynn score of the elbow function. Results All patients were followed up for 6 ～ 24( 11. 3 ± 6. 7) months. The hospitalization time,clinical healing time of fractures and bony healing time in the observation group were all shorter than those in the control group( P < 0. 05). There were no statistical differences in the Baumann angle,the lateral and anteroposterior displacement,and the classification of displacement degree of the distal fracture fragment between the two groups after the operation( P > 0. 05). At the last follow-up,the excellent and good rate of elbow joint function therapeutic effect and joint range of motion in the observation group were higher( larger) than those in the control group( P < 0. 05). There was no statistical difference in the incidence of complications between the two groups( P >0. 05). Conclusions For the treatment of Gartland type Ⅲ supracondylar fractures of the humerus in children,closed reduction and percutaneous crossed Kirschner wire internal fixation can effectively shorten the hospital stay,clinical healing time of fractures and bony healing time,and which can improve the function of the elbow joint.更多还原