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目的介绍肘前入路复位并交叉克氏针固定治疗儿童GartlandⅢ型肱骨髁上骨折的手术方法与临床疗效。方法 2007年4月至2015年4月我们收治GartlandⅢ型骨折患儿120例,均采用肘前L形小切口复位,运用肱骨内外髁交叉克氏针固定,术后3~4周拆除固定并行个体化功能锻炼,术后24周根据Flynn肘关节临床功能评定标准对患儿进行功能及外观评价。结果 120例患儿手术后均获得满意复位与固定,无尺神经损伤,随访24~36周,平均23周。出现肘内翻2例,发生率1.67%,24周疗效评价优良率93.3%。结论肘前入路并交叉克氏针固定可实现骨折的安全快速解剖复位与固定,无严重并发症,能兼顾功能与外观,是部分儿童GartlandⅢ型肱骨髁上骨折的有效治疗方法。
Objective To introduce the surgical approach and clinical efficacy of anterior approach reduction and cross Kirschner wire fixation for the treatment of Gartland Ⅲ supracondylar humerus fractures in children. Methods From April 2007 to April 2015, 120 children with Gartland type Ⅲ fracture were treated with small incision of L-shaped anterior elbow. They were fixed with crossed Kirschner wires in the medial and lateral humerus. After 3 to 4 weeks, fixed parallel individuals Functional exercise, functional and visual evaluation of children after 24 weeks according to Flynn elbow clinical evaluation criteria. Results All the 120 cases were satisfactorily reset and fixed without ulnar nerve injury. The patients were followed up for 24-36 weeks with an average of 23 weeks. There were 2 cases of cubitus varus, the incidence of 1.67%, 24 weeks efficacy evaluation of excellent and good rate of 93.3%. Conclusions Anterolateral approach and cross Kirschner wire fixation can be used to safely and quickly dissect and fix the fracture without any serious complication and function and appearance. It is an effective treatment for the Gartland type Ⅲ supracondylar humerus fractures in some children.