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目的 :小儿肱骨髁上不稳定型骨折并发症多 ,治疗不当经常会产生严重后遗症。该文旨在观察闭合复位后经皮克氏针交叉固定治疗此类骨折的临床疗效。方法 :回顾性临床研究 14例小儿肱骨髁上不稳定型骨折病人经全麻下行闭合复位 ,经皮克氏针交叉内固定治疗效果及并发症的分析。结果 :平均随访 10个月 (6～ 12个月 ) ,所有骨折术后 4周骨痂愈合良好 ,拔除克氏针。术后 8周肘关节功能恢复。 2例暂时性神经麻痹病人术后 12周和 16周神经功能完全恢复。 2例早期肌间膈综合征病人复位固定后症状消失 ,无肘关节畸形和永久性神经血管损伤发生。结论 :闭合复位经皮克氏针交叉内固定是治疗小儿肱骨髁上移位不稳定型骨折的理想的选择方法。
Objective: Pediatric supracondylar humeral unstable fractures and more, improper treatment often have serious sequelae. The purpose of this paper is to observe the clinical effect of percutaneous Kirschner wire cross fixation for the treatment of such fractures after closed reduction. Methods: The retrospective clinical study of 14 cases of pediatric supracondylar humeral unstable fracture patients undergoing general anesthesia with closed reduction and percutaneous Kirschner wire cross fixation and analysis of the complications. Results: The average follow-up of 10 months (6 to 12 months), 4 weeks after all fractures callus healing well, removal of Kirschner wire. 8 weeks after the elbow function recovery. 2 cases of patients with temporary nerve paralysis after 12 weeks and 16 weeks of nerve function fully restored. Two patients with early myophthalmitis syndrome, the symptoms disappeared after fixation, no elbow joint deformity and permanent neurovascular injury occurred. Conclusion: Closed reduction and percutaneous Kirschner wire fixation is an ideal method for the treatment of unstable supracondylar humerus fractures in children.