CAJ | 학술논문

目的：探讨闭合复位内外侧3针交叉固定治疗Gartland Ⅲ型儿童肱骨髁上骨折的疗效。方法对195例Gartland Ⅲ型儿童肱骨髁上骨折患者行闭合复位后,C臂机监视下先在肱骨髁外侧用2枚克氏针平行或交叉固定,再伸直肘关节到50°,保护尺神经下用1枚克氏针在内侧交叉固定,术后长臂石膏托固定于肘关节伸直70°制动3周。结果195例均获随访,时间5~35个月。出现医源性尺神经损伤2例,肘内翻畸形需截骨矫形1例,肘部前侧局限性骨化4例。按Flynn标准评定疗效：优180例,良8例,一般6例,差1例,优良率为96.4%。结论闭合复位内外侧3针交叉固定治疗Gartland Ⅲ型儿童肱骨髁上骨折可有效减少医源性尺神经损伤,降低肘内翻畸形发生率,疗效满意。
목적：탐토폐합복위내외측3침교차고정치료Gartland Ⅲ형인동굉골과상골절적료효。방법대195례Gartland Ⅲ형인동굉골과상골절환자행폐합복위후,C비궤감시하선재굉골과외측용2매극씨침평행혹교차고정,재신직주관절도50°,보호척신경하용1매극씨침재내측교차고정,술후장비석고탁고정우주관절신직70°제동3주。결과195례균획수방,시간5~35개월。출현의원성척신경손상2례,주내번기형수절골교형1례,주부전측국한성골화4례。안Flynn표준평정료효：우180례,량8례,일반6례,차1례,우량솔위96.4%。결론폐합복위내외측3침교차고정치료Gartland Ⅲ형인동굉골과상골절가유효감소의원성척신경손상,강저주내번기형발생솔,료효만의。
Objective To investigate the curative effect of closed reduction of fracture of medial and lateral three pin fixation for treatment of Gartland typeⅢsupracondylar humeral. Methods 195 cases of Gartland typeⅢsupracon-dylar fracture of humerus in children were treated with closed reduction, C-arm machine monitoring in condyle of hu-merus lateral with 2 Kirschner wires parallel or cross fixed, then straighten the elbow joint to 50°, ulnar nerve protec-ted with 1 Kirschner wires in the medial cruciate fixation, and long arm plaster fixed at elbow extension 70° postoper-atively, braked for 3 weeks. Results 195 cases were followed up for 5~35 months. The appearance of 2 cases of i-atrogenic ulnar nerve injury, cubitus varus deformity needed osteotomy in 1 case, 4 cases of elbow anterior localized ossification. According to Flynn standard effect:excellent in 180 cases, good in 8 cases, general in 6 cases, poor in 1 case, the excellent and good rate was 96. 4%. Conclusions Closed reduction and internal and external side three pins fixation for treatment of Gartland type Ⅲ supracondylar fractures of the humerus in children can effectively re-duce iatrogenic ulnar nerve injury, reduce the incidence of cubitus varus deformity,and get satisfactory effect.