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目的:通过临床病例资料分析探讨肱骨外上髁切口在小儿肱骨髁上骨折临床治疗中的疗效,为今后手术切口的选择提供参考。方法:选取2013年1月至2013年12月期间我院(含笔者原单位宜宾县骨科医院)收治的60例肱骨髁上骨折(GartlandⅢ型)患儿作为本组研究的观察对象,所有患者入院后均经急诊手法复位,后由于骨折不稳定或对位不理想改行手术治疗;手术均选择肱骨外上髁切口,直视下对合骨折并用2枚克氏针交叉固定,术后石膏固定4周,对患儿进行半年以上的随访,并对治疗效果进行评价。结果:随访中,60例患儿中优21例,良33例,中4例,差2例,优良率为90%;发生肘内翻3例,肘关节伸屈功能受限2例,未发生血管、神经并发症。结论:采用肱骨外上髁切口联合克氏针内固定治疗小儿肱骨髁上骨折具有组织损伤小、稳定性高、肘关节功能恢复好等优点,而且手术操作简单,术后血管、神经并发症发生率低,可以在临床中推广。
Objective: To investigate the curative effect of the lateral humeral condyles incision in the clinical treatment of supracondylar fractures of humerus by clinical data, and to provide a reference for future surgical incision. Methods: From January 2013 to December 2013, 60 children with supracondylar humeral fractures (Gartland Ⅲ type) treated in our hospital (including the former Yibin orthopedic hospital) were selected as the observation group and all the patients were admitted to hospital After emergency measures were reset, after the fracture due to instability or alignment is not ideal diverting surgery; surgery were selected lateral epicondyle incision, under direct vision on the fracture and combined with two Kirschner wire fixation, postoperative cast immobilization 4 Week, the children were followed for more than six months, and the evaluation of the treatment effect. Results: In the follow-up, 60 cases were excellent in 21 cases, good in 33 cases, fair in 4 cases, poor in 2 cases, the excellent and good rate was 90%; 3 cases of elbow varus occurred, elbow flexion and extension was limited in 2 cases, Vascular, neurological complications occur. Conclusion: The use of humeral epicondyle incision combined with Kirschner wire fixation of supracondylar humerus fractures in children with small tissue damage, high stability, good recovery of elbow function, and the operation is simple, postoperative vascular, neurological complications Low rate, can be promoted in the clinic.