生物骨科材料与临床研究2025，Vol.22Issue(2)：65-70,6.DOI:10.3969/j.issn.1672-5972.2025.02.011
闭合复位两种穿针方式治疗儿童Gartland Ⅲ型肱骨髁上骨折的疗效对比
Comparison of the efficacy of closed reduction with two types of piercing methods in the treatment of Gartland type Ⅲ supracondylar humeral fractures in children
杨青 1秦海江 1李晋惠 1沈伟超 1吴永贵 1李泽青1
作者信息
- 1. 晋城市人民医院骨科,山西 晋城,048000
- 折叠
摘要
Abstract
Objective To compare the efficacy of closed reduction combined with percutaneous unilateral pinning fixation and closed reduction combined with percutaneous cross pinning fixation in the treatment of Gartland type Ⅲ extended supracondylar humeral fractures in children,and to explore the relationship between the direction of different types of fracture lines in the coronal plane and the pinning method.Methods A retrospective study was conducted on 46 children with Gartland type Ⅲ extended supracondylar humeral fractures admitted to Jincheng People's Hospital from January 2021 to June 2023.They were divided into group A and group B according to the different treatment methods:Group A(23 cases)underwent closed reduction and percutaneous fixation with three radial Kirschner wires,and group B(23 cases)underwent closed reduction and percutaneous cross-pinning fixation with two radial and one ulnar Kirschner wires.The two groups were compared in terms of operation time,fracture healing time,carrying angle,Baumann angle,elbow flexion and extension range of motion,forearm rotation range of motion,and complications.The Flynn elbow function standard was used to evaluate the excellent and good rates of the two groups.Results The follow-up period ranged from 6 to 12 months,with an average of(8.00±2.12)months.The operation time in group A was shorter than that in group B(P<0.05).The carrying angle in group A was smaller than that in group B,and the Baumann angle was larger than that in group B,but the difference was not statistically significant(P>0.05).At the 6-month follow-up after surgery,there was no significant difference in elbow flexion and extension range of motion and forearm rotation range of motion between the two groups(P>0.05).No myositis ossificans occurred in either group at the last follow-up;there were 2 cases of cubitus varus in group A and 1 case of cubitus valgus in group B;there was no iatrogenic ulnar nerve injury in group A and 1 case in group B;there was no significant difference in the overall complication rate between the two groups(P>0.05).The excellent and good rate of Flynn score in group A was 82.61%(19/23),and the excellent and good rate of Flynn score in group B was 86.96%(20/23).There was no significant difference in clinical efficacy(P>0.05).Conclusion ① Both insertion methods can achieve satisfactory results in the treatment of Gartland type Ⅲ supracondylar fractures.The unilateral insertion fixation has a short operation time and a low incidence of ulnar nerve injury.The cross insertion fixation can obtain more reliable fixation to maintain the reduction effect during the operation.② According to the different types of fracture lines on the coronal plane to choose the appropriate pinning fixation method.关键词
儿童/肱骨髁上骨折/Gartland Ⅲ型/闭合复位/穿针方式/克氏针固定Key words
Children/Supracondylar humeral fracture/Gartland type Ⅲ/Closed reduction/Piercing method/Kirschner wire fixation分类
医药卫生引用本文复制引用
杨青,秦海江,李晋惠,沈伟超,吴永贵,李泽青..闭合复位两种穿针方式治疗儿童Gartland Ⅲ型肱骨髁上骨折的疗效对比[J].生物骨科材料与临床研究,2025,22(2):65-70,6.
