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目的探讨肱骨外髁重建钛板内固定治疗儿童尺偏型肱骨髁上骨折的方法和疗效。方法对于儿童尺偏型肱骨髁上骨折采用术前测量CA角和BA角的丢失角度[CA角平均丢失(10±5.6)度,BA角平均丢失(8±3.1)度],采用肱骨髁上外侧切口,暴露骨折断端,克氏针横行穿入肱骨髁上骨折远端撬拨复位,于肱骨远端外侧放置折弯后的重建钛板固定。术后石膏屈肘位固定2周后去除开始屈伸锻炼,术后3个月取出钛板。结果 29例患儿随访时间(18±5.6)个月,骨折均Ⅰ期愈合,愈合时间(3.6±0.4)周,CA角、BA角术中均完全纠正,术后Flynm临床评价优秀率为93.1%,未发现骨骺损伤及早闭,随访期无一例发生肘内翻。结论肱骨外髁重建钛板内固定治疗儿童尺偏型肱骨髁上骨折可有效避免肘内翻的发生,早期锻炼肘关节功能,内固定可促进骨折愈合。
Objective To investigate the method and effect of external fixation of titanium plate with humeral condyle reconstruction on supracondylar fracture of humerus in children. Methods Preoperative measurement of CA angle and BA angle loss [mean loss of CA angle (10 ± 5.6) degrees, average loss of BA angle (8 ± 3.1) degrees) was performed on pediatric partial ulnar humerus supracondylar fractures using the supracondylar humerus Lateral incision, exposing the fracture ends, Kirschner wire transverse penetrating humeral supracondylar fracture poking reset, placed in the distal humerus bending the reconstruction of the titanium plate fixation. Postoperative gypsum elbow position fixed for 2 weeks to start flexion and extension exercise, remove the titanium plate after 3 months. Results The follow-up time was 18 ± 5.6 months in 29 cases. All the fractures healed in the first stage and the healing time was 3.6 ± 0.4 weeks. The corrected CA and BA angles were all corrected. The excellent rate of postoperative Flynm clinical evaluation was 93.1 %, Did not find epiphyseal injury and early closure, no case of elbow varus during the follow-up period. Conclusion The treatment of partial ulnar humerus supracondylar fractures with external fixation of the humeral condyles can effectively prevent the occurrence of cubitus varus. Early exercise elbow function and internal fixation can promote fracture healing.