目的:探讨采用三维手法闭合复位经皮克氏针交叉内固定治疗儿童肱骨髁上骨折的临床疗效。方法:自2005年6月-2008年1月采用三维手法闭合复位经皮克氏针交叉内固定术,治疗儿童肱骨髁上骨折47例,所有骨折均为闭合性骨折,无神经血管损伤。患者年龄4～12岁,平均7.3岁。患儿在受伤后5～8h内接受急诊手术。从肘关节的功能和外观两方面进行疗效评价。结果:术后随访时间7～30个月,平均16个月。所有骨折均为术后3～5周达到临床愈合,并拔除克氏针,治疗过程中未出现骨折再移位。术后无一例肘内翻等并发症。按Flynm评分:优31例,良12例,一般4例,差0例。肘关节伸屈活动丢失是影响治疗结果的主要原因,但这种活动受限会随着时间的延长而有所改善。结论:采用三维手法闭合复位经皮克氏针交叉内固定治疗儿童肱骨髁上骨折手术创伤小、固定可靠,可以获得良好的肘关节功能和外形,减少并发症。 Objective: To investigate the clinical effect of closed reduction and percutaneous pinning of Kirschner supracondylar humerus fractures by three-dimensional manipulation. Methods: From June 2005 to January 2008, 47 cases of supracondylar fractures of humerus were treated with closed reduction and percutaneous pinning with Kirschner wires in all three cases. All fractures were closed fractures without neurovascular injury. Patients aged 4 to 12 years, mean 7.3 years. Children received emergency surgery within 5 to 8 hours after injury. From the elbow function and appearance of efficacy evaluation. Results: The follow-up time was 7 to 30 months with an average of 16 months. All fractures were clinically cured 3 to 5 weeks after surgery, and Kirschner wire was removed. No fractures were transplanted during the treatment. No case of cubitus varus and other complications after surgery. By Flynm score: excellent in 31 cases, good in 12 cases, generally 4 cases, poor in 0 cases. Loss of flexion and extension activities in the elbow is a major cause of treatment outcome, but this limitation of activity may improve over time. Conclusion: The three-dimensional manipulation of closed reduction and percutaneous Kirschner wire fixation of supracondylar humerus fractures in children with small trauma, reliable fixation, can get a good elbow function and shape, reduce complications.