临床小儿外科杂志
臨床小兒外科雜誌
림상소인외과잡지
JOURNAL OF CLINICAL FEDIATRIC SURGERY
2014年
3期
180-184
,共5页
骨折固定术,内%肱骨骨折%儿童
骨摺固定術,內%肱骨骨摺%兒童
골절고정술,내%굉골골절%인동
Fracture Fixation,Internal%Humeral Fractures%Child
目的：探讨空心钉克氏针内固定手术治疗儿童陈旧性肱骨外髁骨折的临床疗效。方法回顾性分析2009年10月至2012年12月我们收治并获完整随访的的11例肱骨外髁陈旧性骨折患儿临床资料，其中男9例，女2例，年龄2岁1个月至6岁4个月，平均4岁5个月。患儿受伤至手术时间为30～90 d，平均52 d。受伤初期按Milch分型，MilchⅠ型4例，MilchⅡ型7例，肘关节功能有不同程度受限。患儿均切开复位后用1枚空心钉外加2枚交叉克氏针内固定治疗。术后随访观察骨折愈合时间及并发症情况，术后1年采用Dhillon评分值和Baumann角评定疗效。结果所有患儿术后均获12～34个月（平均22．7个月）随访。均在术后6～8周获骨性愈合。术后1年按照Dhillon评分标准，10例为优，1例为良，优良率100％，术前患侧肘关节活动弧度平均为90．5°±27．3°，术后1年时平均为129．1°±11．8°，二者差异有统计学意义（t＝6．527，P＝0．000）。术后1年所有患儿Baumann角均在正常范围（68°～80°），平均74．3°±4．2°。无一例发生术后感染、骨折延迟愈合、畸形愈合、骨不连、肘内外翻、肱骨小头缺血坏死、医源性血管神经损伤等并发症。结论切开复位后采用1枚空心钉外加2枚交叉克氏针内固定治疗儿童陈旧性肱骨外髁骨折可达到复位满意、内固定稳定和良好的近期疗效，并发症少。
目的：探討空心釘剋氏針內固定手術治療兒童陳舊性肱骨外髁骨摺的臨床療效。方法迴顧性分析2009年10月至2012年12月我們收治併穫完整隨訪的的11例肱骨外髁陳舊性骨摺患兒臨床資料，其中男9例，女2例，年齡2歲1箇月至6歲4箇月，平均4歲5箇月。患兒受傷至手術時間為30～90 d，平均52 d。受傷初期按Milch分型，MilchⅠ型4例，MilchⅡ型7例，肘關節功能有不同程度受限。患兒均切開複位後用1枚空心釘外加2枚交扠剋氏針內固定治療。術後隨訪觀察骨摺愈閤時間及併髮癥情況，術後1年採用Dhillon評分值和Baumann角評定療效。結果所有患兒術後均穫12～34箇月（平均22．7箇月）隨訪。均在術後6～8週穫骨性愈閤。術後1年按照Dhillon評分標準，10例為優，1例為良，優良率100％，術前患側肘關節活動弧度平均為90．5°±27．3°，術後1年時平均為129．1°±11．8°，二者差異有統計學意義（t＝6．527，P＝0．000）。術後1年所有患兒Baumann角均在正常範圍（68°～80°），平均74．3°±4．2°。無一例髮生術後感染、骨摺延遲愈閤、畸形愈閤、骨不連、肘內外翻、肱骨小頭缺血壞死、醫源性血管神經損傷等併髮癥。結論切開複位後採用1枚空心釘外加2枚交扠剋氏針內固定治療兒童陳舊性肱骨外髁骨摺可達到複位滿意、內固定穩定和良好的近期療效，併髮癥少。
목적：탐토공심정극씨침내고정수술치료인동진구성굉골외과골절적림상료효。방법회고성분석2009년10월지2012년12월아문수치병획완정수방적적11례굉골외과진구성골절환인림상자료，기중남9례，녀2례，년령2세1개월지6세4개월，평균4세5개월。환인수상지수술시간위30～90 d，평균52 d。수상초기안Milch분형，MilchⅠ형4례，MilchⅡ형7례，주관절공능유불동정도수한。환인균절개복위후용1매공심정외가2매교차극씨침내고정치료。술후수방관찰골절유합시간급병발증정황，술후1년채용Dhillon평분치화Baumann각평정료효。결과소유환인술후균획12～34개월（평균22．7개월）수방。균재술후6～8주획골성유합。술후1년안조Dhillon평분표준，10례위우，1례위량，우량솔100％，술전환측주관절활동호도평균위90．5°±27．3°，술후1년시평균위129．1°±11．8°，이자차이유통계학의의（t＝6．527，P＝0．000）。술후1년소유환인Baumann각균재정상범위（68°～80°），평균74．3°±4．2°。무일례발생술후감염、골절연지유합、기형유합、골불련、주내외번、굉골소두결혈배사、의원성혈관신경손상등병발증。결론절개복위후채용1매공심정외가2매교차극씨침내고정치료인동진구성굉골외과골절가체도복위만의、내고정은정화량호적근기료효，병발증소。
Objetive To discuss the short-term effect of cannulated screw with K-wires used as internal fixation in management of pediatric neglected humeral lateral condylar fractures. Methods The clinical data of 1 1 cases with neglected humeral lateral condylar fracture were analyzed retrospectively.from October 2009 to December 2012.There were 9 boys and 2 girls,aged from 2 years and 1month to 6 year and 4 months old (aver-age,4 years and 5 months).The duration of initially trauma to surgery ranged from 30 to 90 days (average,52 days).According to Milch classification,there were 4 cases of type Ⅰ and 7 cases of type Ⅱ.Elbow function was limited to varying degrees.All patients were fixated with one cannulated screw with two crossed K-wires and followed-up postoperatively,fracture healing time and complications were observed,Dhillon score and Baumman angle were used to assess elbow function at one-year follow-up. Results All 1 1 patients were fol-lowed up from 12 to 34 months (average,22.7 months).Fracture healing was achieved 6 to 8 weeks postopera-tively.At one-year follow up,by the Dhillon score,10 patients got 9 points and 1 patient got 8 points,presenting a 100% good to excellent rate;the average pre-operation elbow range of motion was (90.5°±27.3°),im-proved to (129.1°±11.8°)one year postoperatively,with a significant difference.The average Baumman an-gle was(74.3°±4.2°)(ranged from 68°to 80°).No post-operative injection,delayed union,malunion,nonun-ion,cubitus valgus or varus,capitellum necrosis or iatrogenic lesions to vessels and nerves occurred. Conlu-sion Cannulated screw with K-wires internal fixation can lead to satifactory reduction,stable internal fixation and excellent short-term functional outcomes and fewer complications.
