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目的探讨克氏针外髁两针固定与克氏针内外髁交叉三针固定治疗儿童肱骨髁上骨折的疗效,为临床选择合理术式提供参考。方法选取本院2011年1月至2013年1月收治的儿童肱骨髁上骨折患儿148例,按克氏针固定方式分为A组(62例)与B组(86例),A组患儿行克氏针外髁两针固定,B组患儿行克氏针内外髁交叉三针固定。术后对比两组疗效、愈合时间、患肢运动力学表现及并发症发生情况。结果术后B组患儿提携角、屈伸丢失、前臂力量均优于A组,差异均有显著性(P<0.05);B组患儿治疗优良率(97.67%)明显优于A组(85.48%)(χ2=7.234,P=0.015);A组患儿并发症发生率(12.90%)显著高于B组(1.16%),差异显著(χ2=9.121,P=0.001)。结论克氏针内外髁交叉三针固定可以取得更稳定的支撑效果,疗效优于克氏针外髁两针固定,临床可考虑优先选择该术式。
Objective To investigate the curative effect of two Kirschner external condyle fixation and Kirschner internal and external condyle cross three-needle fixation on supracondylar fracture of humerus in children, and to provide a reference for clinical choice of reasonable surgical procedures. Methods A total of 148 children with supracondylar humerus fractures admitted from January 2011 to January 2013 in our hospital were divided into group A (62 cases) and group B (86 cases) according to the Kirschner wire fixation. Group A Pediatric Kirschner wire condyle two needle fixation, B group of children Kirschner wire condyle cross three needle fixation. The postoperative efficacy of the two groups were compared, the healing time, limb mechanics performance and the incidence of complications. Results Compared with group A, the carrying angle, loss of flexion and extension of forearm in group B were significantly higher than those in group A (P <0.05). The excellent and good rate of treatment in group B (97.67%) was significantly better than that in group A (85.48 %) (χ2 = 7.234, P = 0.015). The incidence of complications in group A (12.90%) was significantly higher than that in group B (1.16%) (χ2 = 9.121, P = 0.001). Conclusion Kirschner pin fixation of the medial and lateral condyle can achieve a more stable support effect, the effect is superior to the Kirschner wire condyle two-pin fixation, the clinical may consider giving priority to the operation.