目的探讨闭合复位结合 Ilizarov 环形外固定架治疗儿童股骨髁上骨折的临床疗效。方法2008年9月至2014年7月，我科采用闭合复位结合Ilizarov环形外固定架治疗儿童股骨髁上骨折18例。其中男12例，女6例；年龄5～14岁，平均(10.3±1.8)岁。按Muller股骨远端骨折分型：A1型6例，A2型9例，A3型3例。2例累及骨骺，均为Salter-Harris I型骨折。记录手术距离受伤时间，术后住院时间，术后的并发症、处理及结果，骨折愈合的时间。并于术后6个月、1年测量并记录双下肢长度、生理力线及股骨远端骨骺发育情况。末次随访采用膝关节Kolment评定标准评价膝关节功能。结果本组术后随访13～60个月，平均(33.1±2.2)个月。手术距离受伤时间为2～6天，平均为(3.1±0.8)天。术后3～5天出院，平均(3.7±0.9)天。无一例发生神经血管损伤、骨折端再移位、再骨折、外固定架松动、骨髓炎及骨化性肌炎。骨折骨性愈合时间为8～12周，平均(9.7±1.5)周，无骨不愈合或延迟愈合。2例骨折患者软组织挫伤严重，加强换药后伤口愈合。2例针道感染，给予加强换药后愈合。与健侧肢体比较，膝关节伸屈功能恢复良好，无明显差别。无骨骺发育异常。1例较健侧出现3°的外翻畸形，3例较健侧延长0.7 cm、1.0 cm及1.0 cm，未行特殊处理，术后随访至2年时恢复正常。膝关节Kolment评定都为优，优良率为100%。结论闭合复位结合Ilizarov 环形外固定架是治疗儿童股骨髁上骨折的理想方法，具有操作简单、固定牢固、创伤小、恢复快、能避免对骺板的损伤等优点。“,”Objective To investigate the clinical effects of closed reduction with Ilizarov external ifxtor in the treatment of supracondylar fractures of the femur in pediatric patients. Methods A total of 18 pediatric patients with supracondylar fractures of the femur were treated by closed reduction with Ilizarov external ifxtor from September 2008 to July 2014. There were 12 males and 6 females, whose mean age was ( 10.3 ± 1.8 ) years old ( range:5-14 years old ). According to Muller classiifcation of distal femoral fractures, there were 6 cases of A1 type, 9 cases of A2 type and 3 cases of A3 type. With the epiphysis involved in 2 cases, they were Salter-Harris I fractures. The time from injury to operation, postoperative hospital stay, postoperative complications, treatment and results and fracture healing time were recorded. The limb length, limb alignment and epiphyseal development of the distal femur were measured and recorded at 6 months and 1 year after the operation. The knee joint function was evaluated by Kolment knee function evaluation standard at the latest follow-up. Results The patients were followed up for 13 to 60 months ( mean:33.1 ± 2.2 months ). The time from injury to operation was from 2 to 6 days ( mean:3.1 ± 0.8 days ). The postoperative hospital stay was 3 to 5 days ( mean:3.7 ± 0.9 days ). There was no neurovascular injury, fracture re-displacement, re-fracture, external ifxation loosening, osteomyelitis or myositis ossiifcans. The fracture healing time was from 8 to 12 weeks ( mean:9.7 ± 1.5 weeks ), without bone non-union or delayed union. Severe soft tissue contusion was noticed in 2 cases, and wound healing was achieved after the dressing change. There were 2 cases of pin tract infection, and wound healing was achieved after the dressing change. Compared with the contralateral limb, the extension and lfexion function of the knee joint was recovered, without signiifcant differences. Compared with the contralateral limb, 3° valgus deformitywas found in 1 case, and extension of 0.7 cm, 1.0 cm and 1.0 cm in 3 cases. No special treatment was carried out, and they returned to normal at 2 years during the follow-up. According to Kolment knee function evaluation standard, the excellent and good rate was 100%. Conclusions Closed reduction with Ilizarov external ifxator is the ideal way for the treatment of supracondylar fractures of the femur in pediatric patients. It has the advantages of simple operation, stable ifxation, small trauma and quick recovery and avoids the damage to the epiphyseal plate.