临床小儿外科杂志2011，Vol.10Issue(3)：170-173,4.DOI:10.3969/j.issn.1671-6353.2011.03.004
小切口克氏针内固定术治疗儿童肱骨髁间骨折的可行性探讨
Operative treatment of humeral intercondylar fracture in children with minimally invasive incision and percutaneous pinning.
摘要
Abstract
Objective To investigate the operative procedure and the therapeutic effects of minimally invasive incision and percutaneous pinning in operative treatment of humeral intercondylar fracture in children.Methods From January 2005 to September 2010,22 patients with humeral intercondylar fracture were treated with minimally invasive incision and percutaneous pinning. There were 16 males and 6 females, aged from 1 to 11 years (5. 5 years on average) . There were 12 cases of Riseborough-Radin type-Ⅱ, type-Ⅲ in 8 cases, and type Ⅳ in 2cases. Injury was caused by sports in 15 cases,by traffic accident in 3 cases,by falling from height in 3 cases , and by earthquake in 1 case. All fractures were closed , complicating other fracture in 10 cases, radial nerve injury in 5 cases , ulnar nerve injury in 1 cases, brachial artery injury in 1 cases , and forearm compartment syndrome in 3cases. The time from injury to hospitalization was 1 hour to 7 days. Neurovascular repair was performed at the same period. Results All incisions healed by first intention, no related complications occurred. 16 cases of postoperative X-ray films showed anatomical reduction,6 patients with mild shift. A total of 20 patients were followed up 6 months to 3 years ( 12 months on average) . X-ray films showed fracture healed within 2-4 months (2. 5 months on average) . Cubitus varus occurred in 3 cases,but the functions of elbow flexion and extension were good , continue to function exercise and follow-up observation. According to the Flynn et al criteria , the results were excellent in 14 cases , good in 3 cases , and fair in 3 cases; the excellent and good rate was 85％ . Only a small incision scar was found, the function retumed to normal in the cases complicated by nerve and blood vessel injury. Conclusion Minimally invasive incision and percutaneous pinning for operative treatment of humeral intercondylar fracture in children is a safe and effective surgical procedure ,which has minimal trauma , short surgery time , quick recovery , simple operation , and can be effective in reducing the complications ,especially for type Riseborough-Radin Ⅱ, Ⅲ-type fractures best.关键词
肱骨髁间骨折/儿童/手术治疗/小切口Key words
humeral intercondylar fracture / Children/ Operative treatment/ Minimally invasive incision引用本文复制引用
蒋欣,王道喜,陈小亮,唐学阳,刘利君..小切口克氏针内固定术治疗儿童肱骨髁间骨折的可行性探讨[J].临床小儿外科杂志,2011,10(3):170-173,4.基金项目
本课题为国家自然科学基金课题"超声微泡促进BMP-2基因体内转染和表达治疗骨缺损的实验研究"(编号:81071475)资助项目. （编号:81071475）
