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目的探讨影响闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折临床疗效因素。方法回顾性分析我院2010年7月~2012年12月52例采用闭合复位经皮克氏针固定治疗儿童肱骨髁上骨折的临床资料,其中男35例,女17例,年龄2.5~12岁,平均6.7岁,11例GarlandⅡ型,41例GarlandⅢ型,51例伸直型,1例屈曲型;分析在临床治疗过程中影响该方法疗效的相关因素。结果本组52例均得到随访12~18个月,按照肘关节功能评价Flynn标准进行评价,其中优41例,良8例,可3例,差0例。优良率94.2%。结论微创治疗儿童肱骨髁上骨折具有创伤小、恢复快、骨折固定稳定、预防骨筋膜室综合征及Volkmann挛缩、防止肘内翻、肘关节功能好等优点;但术中术后相关因素影响预后,如反复复位、复位不佳、未注意对神经血管的保护、手法不当、尺神经的损伤、克氏针的方向不当、外固定时间过短、锻炼不及时等。
Objective To investigate the clinical effects of closed reduction and percutaneous Kirschner wire fixation on supracondylar humerus fractures in children. Methods The clinical data of 52 cases of supracondylar humerus fractures treated with closed reduction and percutaneous Kirschner wire fixation in our hospital from July 2010 to December 2012 were retrospectively analyzed. There were 35 males and 17 females, aged 2.5-12 years , Average 6.7 years old, 11 cases of Garland Ⅱ type, 41 cases of Garland Ⅲ type, 51 cases of straight type, 1 case of flexion type; analysis of the clinical treatment of the factors that affect the efficacy of the method. Results The 52 cases were followed up for 12 to 18 months, according to the Evaluation of Flynn criteria for elbow function evaluation, including excellent in 41 cases, good in 8 cases, fair in 3 cases and poor in 0 cases. Excellent rate of 94.2%. Conclusion Minimally invasive treatment of supracondylar fractures of humerus has the advantages of less trauma, rapid recovery, stable fracture, prevention of compartment syndrome and Volkmann contracture, prevention of cubitus varus and elbow joint function. However, postoperative related factors Affect the prognosis, such as repeated reset, poor reset, did not pay attention to the protection of nerve blood vessels, improper technique, ulnar nerve injury, Kirschner wire in the wrong direction, external fixation time is too short, exercise is not timely and so on.