克氏针张力带治疗儿童陈旧肱骨外髁骨折疗效观察

目的：初步观察克氏针钢丝张力带对儿童肱骨外髁陈旧骨折的疗效。方法：选取1995年1月至2007年1月我院收治的98例儿童陈旧肱骨髁骨折，按Jakob分型，其中JakobII型37例，JakobIII型61例，行切开复位克氏针钢丝张力带内固定术。观察克氏针钢丝张带治疗儿童陈旧性肱骨外髁骨折的治疗效果，分析并发症发生率与分型有无相关。结果：随访3—5年，平均4．2年，术后6．8周骨折临床愈合。根据Hardacre标准判断疗效，II、III型骨折优良率分别为95％（35／37）、85％（52／61），总优良率为89％（87／98）。并发症发生率为24．5％（24／98），II型为10．8％（4／37），III型为32．8％（20／61），II、III型骨折并发症发生率在统计学上有显著差异（P〈O．05）。结论：切开复位克氏针钢丝张力带内固定能有效重建肘关节外观和功能，对JakobII、JakobIII型骨折治疗均能取得满意效果。III型骨折的并发症发生率明显高于II型骨折。

The Clinical Observation of Kirschner Wire And Tension Band for Old Humeral Lateral Condyle Fracture in Children

Objective： To observe the therapeutic result of kirschner wire and tension band for treating old humeral lateral condyle fractures in children. Methods： From January 1995 to December 2007, 98 cases of humeral lateral condyle fractures, including 37 cases of type II and 61 cases of type III fractures as classified by Jakob classification, were treated by open reduction, internal fixation with kirschner wire and tension band. The therapeutic result was observed and the relationship between complication rate and classification was analyzed. Results： After a follow-up duration of 3-5 years （mean 4.2 years）, the time of bony union was 6-8 weeks. According to Hardacre criteria, the excellent and good rate of types II and III fractures was 95% （35/37） and 85% （52/61） respectively, the total excellent and good rate was 89% （87/98）, the complica- tion rate of types II and III fractures was 10.8% （4/37） and 32.8% （20/61） respectively, the total excellent and good rate was 24.5%（24/98）, there was no significantly different between 2 types in complication rate （P〈0.05）. Conclusion： Open reduction and internal fixation with kirschner wire and tension band for treating old humeral lateral condyle fractures in children can effectively repair and reconstruct the appearance and function of the elbow joint. The result is satisfactory in Jakob II and III fractures.