CAJ | 학술논문

背景:肱骨髁部骨折是创伤骨折较难处理的骨折,由直接或间接的暴力所引起,置入内固定治疗是常用的外科治疗方法.目的:探讨肱骨髁部骨折后不同金属植入物内固定后的力学特点以及不同方法后肘关节的功能情况.方法:交叉克氏针固定的病例分析选取2005年5月至2010年8月收治的儿童肱骨髁上 Gartland Ⅲ型骨折患者32例,采用后侧切口交叉克氏针内固定,外用肘前“8”字绷带包绕固定的方法治疗,通过肘后侧单一切口入路,直视下行骨折解剖复位交叉克氏针内固定,术毕外用肘前“8”字绷带包绕固定.结果与结论:32例患者获得随访,随访时间10-28个月,平均14个月,4-7周骨折全部愈合.按 Flynn评定标准,优19例,良11例,可2例,优良率93.75%.肘关节后侧入路对骨折部位显露充分,骨折易于解剖复位,且便于克氏针准确钻入固定,术后采用可微动的肘前“8”字绷带包绕固定,取得较好的疗效.由于肱骨髁部骨折的力学特点,金属植入物治疗的方法要根据患者的实际病情来决定,当肱骨髁部发生粉碎性骨折时,建议使用交叉克氏针的方法内固定,当髁部骨折块较少的情况下,可以选用钢板置入内固定治疗.
배경:굉골과부골절시창상골절교난처리적골절,유직접혹간접적폭력소인기,치입내고정치료시상용적외과치료방법.목적:탐토굉골과부골절후불동금속식입물내고정후적역학특점이급불동방법후주관절적공능정황.방법:교차극씨침고정적병례분석선취2005년5월지2010년8월수치적인동굉골과상 Gartland Ⅲ형골절환자32례,채용후측절구교차극씨침내고정,외용주전“8”자붕대포요고정적방법치료,통과주후측단일절구입로,직시하행골절해부복위교차극씨침내고정,술필외용주전“8”자붕대포요고정.결과여결론:32례환자획득수방,수방시간10-28개월,평균14개월,4-7주골절전부유합.안 Flynn평정표준,우19례,량11례,가2례,우량솔93.75%.주관절후측입로대골절부위현로충분,골절역우해부복위,차편우극씨침준학찬입고정,술후채용가미동적주전“8”자붕대포요고정,취득교호적료효.유우굉골과부골절적역학특점,금속식입물치료적방법요근거환자적실제병정래결정,당굉골과부발생분쇄성골절시,건의사용교차극씨침적방법내고정,당과부골절괴교소적정황하,가이선용강판치입내고정치료.
@@@@BACKGROUND: Humeral condylar fracture is a kind of trauma fracture that difficult to deal, and caused with direct or indirect violence. Internal fixation is the commonly used surgical treatment method. OBJECTIVE: To explore the mechanical characteristics of humeral condylar fracture after treated with different metal implants as wel as the elbow function after treated with different methods. METHODS: Thirty-two child patients with supracondylar Gartland Ⅲ fractures and treated with cross Kirschner wire fixation were selected from May 2005 to August 2010. Al the patients were treated with osterior incision cross Kirschner wire fixation and antecubital “8” bandage wrapping fixation through elbow rear single incision approach. The downstream fracture was treated withanatomic reduction and cross Kirschner wire fixation. Antecubital “8” bandage wrapping fixation was performed after operation. RESULTS AND CONCLUSION: Al the 32 patients were fol owed-up for 10-28 months, average, in 14 months, and the fracture was healed at 4-7 weeks. According to the Flynn assessment standards, excel ent in 19 patients, good in 11 patients, average in 2 patients, and the excel ent and good rate was 93.75%. The posterior approach of elbow ful y revealed the fracture site, easy for anatomic reduction and easy for Kirschner wire to accurate dril into the fracture site and fixation. And the antecubital “8” bandage wrapping fixation after operation can help to obtain the better efficacy. Due to the mechanics characteristics of humeral condylar fracture, the metal implants treatment should be performed in accordance with the patient’s actual condition, for example, the humeral condylar comminuted fracture should be treated with cross Kirschner wire fixation and the smal condylar fracture should be treated with plate internal fixation.