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目的观察不同入路治疗儿童Gartland Ⅲ型肱骨髁上骨折的临床疗效。方法 2005年1月-2010年10月间,选择某科50例肱骨髁上骨折(Gartland Ⅲ)患儿。随机分为两组:肘后侧入路组(n=25);肘内侧入路组(n=25)。患儿均全麻后,按分组行切开复位克氏针手术治疗。术后石膏外固定4周。照Flyrm临床功能评定标准对肘关节功能进行评价。结果所有病例均得到随访,随访时间12～24个月。平均19个月。骨折均愈合良好。6例神经损伤者在8-10周恢复。随访期内两组各有1例出现肘内翻畸形。肘内侧入路的肘关节优良率为88%,肘后侧入路的肘关节优良率为64%,两者比较差异有统计学意义(P﹤0.05)。结论肘关节内侧入路治疗Gartland Ⅲ型肱骨髁上骨折较后侧入路简便、容易,肘关节功能恢复良好。
Objective To observe the clinical effects of different approaches to the treatment of Gartland Ⅲ supracondylar humerus fractures in children. Methods Between January 2005 and October 2010, 50 children with supracondylar fracture of humerus (Gartland Ⅲ) were selected. Randomly divided into two groups: the elbow posterior approach group (n = 25); elbow medial approach group (n = 25). Children with general anesthesia, according to the group cut open Kirschner wire surgery. Gypsum after external fixation for 4 weeks. According to Flyrm clinical function evaluation criteria elbow function evaluation. Results All patients were followed up for 12-24 months. Average 19 months. All fractures healed well. 6 cases of nerve injury recovered in 8-10 weeks. One case of cubitus varus deformity occurred in both groups during the follow-up period. The excellent and good rate of the elbow in the medial elbow was 88% and the elbow in the posterior elbow was 64%, the difference was statistically significant (P <0.05). Conclusion The treatment of Gartland Ⅲ supracondylar humerus fractures with the medial approach to the elbow is simpler and easier to perform than the posterior approach. The functional recovery of elbow is good.