【摘要】：目的探討空心釘克氏針內(nèi)固定對(duì)兒童陳舊性肱骨外髁骨折的手術(shù)療效。 方法回顧性分析我科2009年10月至2012年12月收治并獲完整隨訪的的11例肱骨外髁陳舊性骨折患兒資料，男9例，女2例，年齡2歲1個(gè)月至6歲4個(gè)月，平均4歲5個(gè)月。患兒受傷至手術(shù)時(shí)間為30～90d，平均52d。受傷初期按Milch分型，Milch型4例，Milchē型7例，肘關(guān)節(jié)功能有不同程度受限。所有患兒均切開(kāi)復(fù)位后采用一枚空心釘外加兩枚交叉克氏針內(nèi)固定治療。術(shù)后隨訪，觀察骨折愈合時(shí)間及并發(fā)癥的發(fā)生，術(shù)后一年采用Dhillon評(píng)分值和Baumann角評(píng)定療效。 結(jié)果所有患者術(shù)后均獲12～34個(gè)月（平均22.7個(gè)月）隨訪。均在術(shù)后6～8周獲骨性愈合。術(shù)后一年按照Dhillon評(píng)分標(biāo)準(zhǔn)10例為優(yōu)，1例為良，優(yōu)良率100%，，術(shù)前患側(cè)肘關(guān)節(jié)活動(dòng)弧度平均為（90.5±27.3°），術(shù)后一年時(shí)平均為（120.1±11.8°），二者間差異有統(tǒng)計(jì)學(xué)意義（t=6.527，P=0.000）。術(shù)后一年所有患兒Baumann角均在正常范圍（68～80°），平均（74.3±4.2°）。無(wú)一例發(fā)生術(shù)后感染、骨折延遲愈合、畸形愈合、骨不連、肘內(nèi)外翻、肱骨小頭缺血壞死、醫(yī)源性血管神經(jīng)損傷等并發(fā)癥。 結(jié)論切開(kāi)復(fù)位后采用一枚空心釘外加兩枚交叉克氏針內(nèi)固定治療兒童陳舊性肱骨外髁骨折可達(dá)到滿意復(fù)位，穩(wěn)定內(nèi)固定和良好的近期療效，并發(fā)癥少。
[Abstract]:Objective to investigate the effect of internal fixation of hollow nail with Kirschner's needle on old fracture of lateral condyle of humerus in children. Methods 11 cases of old fracture of lateral condyle of humerus were retrospectively analyzed from October 2009 to December 2012 in our department. There were 9 males and 2 females, aged from 2 years 1 month to 6 years 4 months, with an average of 4 years and 5 months. The time from injury to operation was 30 to 90 days (mean 52 days). In the early stage of injury, there were 4 cases of Milch type according to Milch classification and 7 cases of Milch type, and the function of elbow joint was limited to different degree. All the children were treated with one hollow nail and two cross Kirschner needles after open reduction. The time of fracture healing and the occurrence of complications were observed. Dhillon score and Baumann angle were used to evaluate the curative effect one year after operation. Results all patients were followed up for 12 ~ 34 months (mean 22.7 months). Bone healing was achieved at 6 to 8 weeks postoperatively. According to Dhillon score, 1 case was excellent and 1 case was good, and the excellent and good rate was 100%. The mean radians of elbow motion were (90.5 鹵27.3 擄) before operation and (120.1 鹵11.8 擄) at one year after operation. There was significant difference between the two groups (t = 6.527P 0.000). The Baumann angle was in the normal range (68 擄80 擄) and the mean value was (74.3 鹵4.2 擄) one year after operation. No postoperative infection, delayed union, malunion, nonunion, cubitus varus, ischemic necrosis of the head of humerus, iatrogenic vascular and nerve injury were found. Conclusion after open reduction, one hollow nail and two cross Kirschner needles can be used to treat the old humeral lateral condylar fracture in children. The treatment can achieve satisfactory reduction, stable internal fixation and good short-term curative effect with fewer complications.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R726.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 吳泉州;王曉林;鄭榮宗;蘭樹(shù)華;葉方;;空心釘治療兒童陳舊性肱骨外髁骨折[J];臨床骨科雜志;2011年03期

2 沈品泉;張菁;陳s

本文編號(hào)：2133241