CAJ | 학술논문

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：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：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：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：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。
배경：교차극씨침내고정시목전치료인동GartlandⅢ형굉골과상골절적수선방법，단잉미종근본상해결병발증발생문제。목적：평개척신경구치침술식치료인동GartlandⅢ형굉골과상골절적가행성급료효。 　　방법：1998년1월도2010년10월채용척신경구치침술식치료인동GartlandⅢ형굉골과상골절환인144례，수방시검사배소지운동급감각정황，측량쌍상지장도、주관절활동도，섭쌍주정위편측량Baumann각혹제휴각。채용HSS주관절공능평개법평분표준진행주관절공능평정。 　　결과：144례환인，수방14~85개월，평균60개월，근거HSS주관절공능평정법행공능평개：우140례，량4례，무주내번화주외번기형발생，무계발척신경손상，지체무단축。 　　결론：척신경구치침술식치료인동GartlandⅢ형굉골과상골절가획득량호적주관절공능급외관，예방료주내번기형급계발척신경손상，차대골후생장발육무명현영향。
Background:Internal fixation with closed Kirschner wires is the preferred treatment for GartlandⅢsupracondylar fracture of humerus in children in recent years. But complications still occurred after the surgery. 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 GartlandⅢsupracondylar fracture of humerus in children. 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 Oc-tober 2010. The length of upper extremities, elbow joint range of motion, Baumann angle and carrying angle were mea-sured. The function of elbow joint was estimated by HSS scoring. 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 val-gus, secondary injury of ulnar nerve or extremity shortness were observed. 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 GartlandⅢsupracondylar fracture of humerus in children. The treatment will not interfere with epiphyseal growth and can prevent from cubitus varus and second-ary ulnar nerve injury.