中国骨伤2011，Vol.24Issue(8)：625-628,4.DOI:10.3969/j.issn.1003-0034.2011.08.002
三根克氏针不同固定方式治疗儿童肱骨髁上骨折的病例对照研究
Case-control study on therapeutic effects of different fixation methods with three Kirschners wires for the treatment of Numeral supracondylar fractures
摘要
Abstract
Objective: To compare therapeutic effects of three fixation methods with three Kirschner wires, and to find the best fixation method. Methods: From July 2008 to May 2009,60 patients with humeral supracondylar fractures were treated.Among patients in Group A, 11 patients were male and 9 patients were female, ranging from 2 to 13 years old, with an average of (5.4±0.5)years; all the patients in Group A were fresh closed fractures without nerve and blood vessel injuries, 13 patients were type Ⅱ and 7 patients were type Ⅲ according to Gartland classification; and all the patients in Group A were treated by three Kirschner wires fixation with the third Kirschner different wire fixed through radial edge of coronoid fossa. Among patients in Group B, 13 patients were male and 7 patients were female, ranging from 2 to 11 years old, with an average of ( 6.1 ±0.4)years;all the patients in Group B were fresh closed fractures without blood vessel injuries, 11 patients were type Ⅱ and 9 patients were type Ⅲ according to Gartland classification, 2 patients had ulnar nerve injuries before treatment; and all the patients in Group B were treated by three Kirschner wires fixation with the third Kirschner different wire fixed through ulnar edge of coronoid fossa.Among patients in Group C, 8 patients were male and 12 patients were female, ranging from 3 to 14 years old, with an average of (7.4±0.6)years; all the patients in Group C were closed fresh fractures without blood vessel injuries,7 patients were type Ⅱ and 13 patients were type Ⅲ according to Gartland classification, 2 patients had radial nerve injuries before treatment ;and all the patients in Group C were treated by three Kirschner wires fixation with the third Kirschner different wire fixed through middle of coronoid fossa. After 1 year of treatment, the Carrying and Baumann angles were measured on the X-ray of all patients in the three groups, and the motion range of elbow joint was observed. The Flynn evaluation criteria were used to compare therapeutic effects among the three groups. Results: All the patients were followed up. The function loss of elbow joint were( 14.04±3.25)°in Group A, ( 13.14±2.34 )° in Group B, and (9.25±2.56) ° in Group C. Changes of Carrying angle were (7.64±1.78)° in Group A; (7.38± 1.68 )° in Group B ,and (5.27± 1.13 )° in Group C. Changes of Baumann angle were (28.55±3.23)° in Group A, ( 27.55±2.23 )° in Group B, (21.45± 1.73 ) ° in Group C. According to Flynn criteria, there were 11 patients got excellent resu1t,4 good and 5 poor in Group A ;in Group B, 12 patients got excellent result, 3 good and 5 poor ;in Group C, 11 patients got excellent result,6 good and 3 poor. The therapeutic effects of Group C was better than those of Group A and Group B. Conclusion: There are different effects among three kinds of operative approaches for the humerus supracondylar fractures. The fixation method with one Kirschner wire through middle part of coronoid fossa is better than the other two fixation methods.关键词
肱骨骨折/骨折固定术,内/肘关节/病例对照研究Key words
Humeral fractures/ Fracture fixation, internal/ Elbow joint/ Case-control studies引用本文复制引用
廖家新,王建伟,张爱国,蔡建平,严松鹤,朱国华..三根克氏针不同固定方式治疗儿童肱骨髁上骨折的病例对照研究[J].中国骨伤,2011,24(8):625-628,4.基金项目
无锡市医院管理中心医学科技发展基金资助面上项目(编号:YGZ1020) （编号:YGZ1020）
