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[目的]探索桡侧入路克氏针加捆绑带内固定治疗Gartland III型儿童肱骨髁上骨折的临床疗效和意义。[方法]51例3~14岁的Gartland III型肱骨髁上骨折患儿,采用应用随机数字表分组的方法,随机分为改良手术组(采用桡侧入路克氏针加捆绑带内固定治疗)和传统手术组(采用传统双侧入路切开复位交叉克氏针内固定治疗)两组。观察两组临床愈合时间、术后1周内神经症状发生率、术后2周后肘关节活动范围、术后3个月后肘内翻畸形发生率、骨化性肌炎发生率、术后第二天及拆除内固定后进行肘部正位X线片B角(即Baumann角)度数、总体疗效评价等指标观察和比较两组的临床疗效。[结果]两组均达临床愈合,肘内翻畸形、神经症状发生率、骨化性肌炎发生率及临床愈合时间比较差异无统计学意义(P>0.05);而两组肘部正位X线片B角度数、肘关节活动范围、总体疗效评价,差异有统计学意义(P<0.05)。[结论]桡侧入路克氏针加捆绑带内固定治疗Gartland III型儿童肱骨髁上骨折具有创伤小,内固定可靠,有效改善肘关节活动范围,降低肘内翻畸形发生率,提高临床疗效的优势,值得临床推广。
[Objective] To explore the clinical efficacy and significance of radial approach Kirschner wire bundled with internal fixation in the treatment of supracondylar fracture of Gartland III children. [Methods] Fifty-one children with Gartland type III supracondylar humerus fractures, aged 3-14 years old, were randomly divided into three groups according to the random number table. The patients in the modified operation group were treated with Kirschner wire plus internal fixation ) And traditional surgery group (using traditional bilateral open reduction and cross Kirschner wire fixation) two groups. The clinical healing time, the incidence of neurological symptoms within 1 week after surgery, the range of elbow motion 2 weeks after surgery, the incidence of cubitus varus deformity and the incidence of ossifying myositis 3 months after operation were observed. The next day after dislocation and internal fixation, the elbow radiographs B angle (Baumann angle) degree, the overall effect evaluation and other indicators to observe and compare the clinical efficacy of the two groups. [Results] The clinical healing, cubitus varus deformity, the incidence of neurological symptoms, the incidence of ossifying myositis and the clinical healing time were not statistically different between the two groups (P> 0.05) X-ray B angle, elbow range of motion, the overall effect evaluation, the difference was statistically significant (P <0.05). [Conclusion] Radial approach with Kirschner wire and banding band fixation for traumatic supracondylar fractures of Gartland III has the advantages of less trauma and reliable internal fixation, effectively improving the range of elbow motion, reducing the incidence of cubitus varus deformity and improving clinical curative effect The advantages of clinical promotion.