儿童肱骨髁上骨折外侧手术入路及克氏针内固定方法的改良

目的：通过回顾性分析探讨采用改良外侧手术入路及克氏针内固定方式治疗儿童肱骨髁上骨折的疗效。方法：比较改良的外侧手术入路及克氏针内固定方式与常规手术入路、克氏针内固定方式治疗儿童肱骨髁上骨折疗效的差异。结果：25例获随访，随访时间11月-4年零6个月，骨折复位对线对位良好，骨折全部愈合，经过功能锻炼后肘关节功能良好，1例轻度肘内翻（〈5°），发生率4％。参照朱盛修的疗效标准，本组优19例，良4例，可2例，优良率92％。结论：改良外侧手术入路、肱骨髁上外侧双克氏针内固定方法治疗肱骨髁上骨折具有手术操作简单，创伤小，骨折复位容易，稳定性可靠，功能恢复良好，可避免医院性神经损害且不增加肘内翻发生率，值得推广。

THE IMPROVEMENT OF LATERAL SURGICAL APPROACH AND KIRSCHNER WIRE FIXATION METHODS ON CHILDREN'S SUPRACONDYLAR FRACTURE OF THE HUMERUS

Objective：To retrospectively analyse the effects of improved lateral surgical approach and Kirschner wire fixation methods on children＇s supracondylar fracture of the humerus.Method：The effects of the improved lateral surgical approach and the internal fixation with Kirschner on treatment of children humerus fractures were eyaluated and the comparison with the conventional method was discussed.Results： 25 cases were followed up,for 11 months to 4 years and 6 months;Reduction of the fracture lines were good. All fractures healed. Patients had good elbow function after exercise. 1 case had mild elbow varus （〈5°）, the incidence is 4%. Reference to the efficacy of standard of Zhu Sheng Xiu,19 cases were excellent,4 cases were good,2 case was general, the excellent and good rate was 92%. Conclusion：The treatment of humeral condyle fracture by the improved lateral surgical approach and the two-wire fixation methods on the lateral humerus has small trauma,easy fracture reduction,stable and reliable,with good functional recovery; it can avoid hospital nerve damage and does not increase the incidence of cubitus varus So it is worth spreading.