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目的探讨折顶手法复位经皮穿针内固定治疗GartlandⅢ型儿童肱骨髁上骨折的复位原理及安全性和临床疗效。方法在屈肘30°～50°位,利用折顶手法复位,闭合穿针,交叉克氏针内固定,术中拍X线片观察或C臂X线机监视下治疗GartlandⅢ型难整复性儿童肱骨髁上骨折。结果平均住院5d,术后随访3～18个月,平均10.5个月,采用Ylynn评价标准,优24例,良9例,可3例,优良率为91.67%。结论折顶手法复位经皮穿针内固定能使软组织张力大、重叠移位的难整复性GartlandⅢ型儿童肱骨髁上骨折避免切开复位,提高了闭合复位的成功率,安全、可行。
Objective To investigate the reduction principle and safety and clinical efficacy of percutaneous pinning and reduction by percutaneous pinning in the treatment of supracondylar fractures of Gartland Ⅲ children. Methods At the elbow flexion of 30 ° ~ 50 °, the treatment of reduction of Gartland Ⅲ type was performed by means of reduction by folding hands, closed needle insertion, cross Kirschner wire fixation, intraoperative X-ray film observation or C-arm X- Children humerus supracondylar fracture. Results The average hospital stay was 5 days. The patients were followed up for 3 to 18 months with an average of 10.5 months. According to the Ylynn criteria, 24 were excellent, 9 were good and 3 were fair. The excellent and good rate was 91.67%. Conclusions The reduction of percutaneous pinning by percutaneous pin fixation can make the tension of soft tissue large and overlapless. The Gartland Ⅲ type supracondylar fractures of the humerus avoid the open reduction and improve the success rate of closed reduction, which is safe and feasible.