目的:分析使用弹性髓内钉经皮克氏针联合撬拨复位治疗儿童桡骨颈O,BrienⅢ型骨折的疗效。方法:根据O,Brien骨折移位分型原则:Ⅰ型≤30°,30°<Ⅱ型≤60°,Ⅲ型>60°。选取2004年3月~2012年8月本科收治的6例儿童桡骨颈O,BrienⅢ型骨折。男4例,女2例;年龄5~13岁,平均8.25岁;右侧4例,左侧2例;摔伤3例,车祸3例;均不伴神经损伤;伴尺骨鹰嘴骨折1例,1例合并肱骨内上髁骨折。均采用弹性髓内钉、经皮2枚克氏针3点联合撬拨复位,弹性髓内钉固定。术后屈肘石膏托固定3周,拆除石膏后功能锻炼。随访6个月~1年,平均随访9个月。结果:1例患儿骨折延迟愈合,给予保守治疗后于11个月愈合。无桡骨头过度生长,无桡骨头骨骺早闭,功能活动良好。1例出现钉尾刺激皮肤引起疼痛,骨折愈合取出后缓解。根据Metaizeau标准评定,优4例,良1例,可1例,优良率83%。结论:弹性髓内钉、经皮克氏针联合撬拨复位治疗儿童桡骨颈O,BrienⅢ型骨折是一种微创,疗效良好的治疗方法。 OBJECTIVE: To analyze the curative effect of using elastic intramedullary nailing combined with percutaneous Kirschner wire and poking to treat O, Brien type Ⅲ fractures of the radial neck in children. Methods: According to O, Brien fracture dislocation principle: Ⅰ type ≤ 30 °, 30 ° <Ⅱ type ≤ 60 °, Ⅲ type> 60 °. Six cases of O, Brien Ⅲ fractures of radial neck were selected from March 2004 to August 2012 in our hospital. 4 males and 2 females; aged 5 to 13 years, mean 8.25 years; 4 on the right side, 2 on the left side; 3 cases on falls and 3 car accidents; none had nerve injury; one case had an olecranon fracture , 1 case of humeral medial condyle fracture. All use of flexible intramedullary nail, percutaneous 2 Kirschner 3 poking reduction combined with flexible intramedullary nailing. Postoperative elbow plaster care for 3 weeks, removal of plaster after functional exercise. All the patients were followed up for 6 months to 1 year with an average follow-up of 9 months. Results: One case had delayed union of fracture and healed at 11 months after conservative treatment. No radial head overgrowth, no radial epiphyseal early closure, functional activity is good. 1 case of nail tail irritation caused by skin pain, fracture healing removed. According to the Metaizeau standard, excellent in 4 cases, good in 1 case and fair in 1 case, excellent and good rate was 83%. Conclusion: Elastic intramedullary nails and percutaneous Kirschner wire combined with poking reduction treatment of children with radial neck O, Brien Ⅲ fracture is a minimally invasive, effective treatment.