摘要
目的探讨外侧进针方式对克氏针治疗GartlandⅢ型儿童肱骨髁上骨折疗效的影响。方法回顾性分析北京儿童医院2017-02至2019-02收治并采用外侧平行克氏针和外侧扇形克氏针两种进针方式的138例GartlandⅢ型儿童肱骨髁上骨折病例资料,其中平行组为外侧平行克氏针固定(65例),扇形组为外侧扇形克氏针固定(73例)。评估两组间的临床特征、末次随访的功能及外观评分,并进行统计学分析。结果共134例获得随访,随访时间6~24个月(平均16个月)。两组病例临床特征无统计学差异,术后根据Flynn功能标准,平行组优良率为93.7%,扇形组优良率为90.3%,差异无统计学意义;根据Flynn美观标准,平行组优良率为92.1%,扇形组优良率为90.1%,差异无统计学意义。所有病例术后未出现骨折再移位、医源性神经损伤、肘内翻等并发症。结论对于GartlandⅢ型儿童肱骨髁上骨折,克氏针外侧平行与外侧扇形两种进针方式均能取得良好的手术效果及预后。
Objective To evaluate the efficacy of lateral divergent or parallel pin fixation using smooth K-wires for the operative management of Gartland typeⅢsupracondylar humerus fractures in children.Methods A retrospective analysis of 138 cases of Gartland typeⅢsupracondylar humeral fractures treated in Beijing Children’s Hospital between February 2017 to February 2019 was conducted.According to fixation methods,the patients were divided into the lateral divergent pin fixation group and the lateral parallel pin fixation group.The clinical features of the two groups and Flynn scores at the last follow-up were compared and analyzed statistically.Results A total of 134 patients were followed up for 6-24 months(mean 16 months).There was no significant difference in clinical characteristics between the two groups.Postoperative evaluation was conducted by Flynn standards.By Flynn’s function standard,the excellent and good rate of parallel group was 93.7%,compared to 90.3%in the divergent group,with no statistically significant difference.By Flynn’s aesthetic standards,the excellent and good rate of the parallel group was 92.1%,and that of the divergent group was 90.1%,so there was no significant difference between the two groups.There were no complications,such as fracture redisplacement,latrogenic nerve injury or cubitus varus.Conclusions Our series demonstrates that both lateral divergent and parallel pin fixations are effective and safe approaches to Gartland typeⅢsupracondylar humerus fractures in children.
作者
朱丹江
王强
孙保胜
宋宝健
冯伟
刘定武
ZHU Danjiang;WANG Qiang;SUN Baosheng;SONG Baojian;FENG Wei;LIU Dingwu(Department of Orthopedics,Affiliated Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)
出处
《武警医学》
CAS
2020年第9期740-744,共5页
Medical Journal of the Chinese People's Armed Police Force
关键词
外侧平行克氏针
外侧扇形克氏针
儿童肱骨髁上骨折
lateral parallel K-wires
lateral divergent K-wires
supracondylar humerus fracture
