肱三头肌两侧入路克氏针张力带治疗肱骨髁上骨折

目的探讨采用肱三头肌两侧入路交叉克氏针加两侧钢丝张力带治疗肱骨髁上骨折的疗效。方法对16例肱骨髁上骨折患者采用肱三头肌两侧入路交叉克氏针加两侧钢丝张力带固定。结果12例获得随访,时间2-41个月。骨折均愈合,功能恢复完全正常11例,轻度受限1例。结论肱三头肌两侧入路结合交叉克氏针加两侧钢丝张力带内固定治疗肱骨髁上骨折,手术创伤小,操作简便,术后可早期活动,值得在基层医院推广。     

双张力带结合双钩状克氏针治疗肱骨髁间粉碎性骨折

目的 探讨使用双张力带结合双钩状克氏针治疗肱骨髁间粉碎性骨折的临床疗效。方法采用双张力带结合双钩状克氏针治疗肱骨髁间粉碎性骨折42例。结果患者全部获得随访,时间6～18个月,骨折均骨性愈合,愈合时间为3．5～6个月。采用改良Cassebaum评分系统评定肘关节功能：优11例,良21例,可8例,差2例,优良率76．2％（32／42）。结论采用双张力带结合双钩状克氏针固定是治疗肱骨髁间粉碎性骨折的有效方法。     

克氏针内固定治疗肱骨内上髁骨折

肱骨内上髁骨折多发于青少年和儿童,约占肘部骨折的10%,可并发肘关节脱位及尺神经损伤.2000年5月～2006年5月,我科采用切开复位克氏针内固定治疗肱骨内上髁骨折22例,取得了良好的效果.     

克氏针治疗舟骨骨折

2005年1月～2007年12月,我们应用切开复位克氏针内固定治疗新鲜舟骨骨折9例,效果满意. 1 材料与方法 1.1 病例资料本组9例,男7例,女2例,年龄19～38岁.右侧6例,左侧3例.按改良Herbert舟骨骨折分型[1]:B1型1例,B2型5例,B3型1例,B4型2例.受伤至手术时间3～11 d.     

改良交叉克氏针治疗髌骨骨折

1998年2月～2011年7月,我科采用交叉克氏针加张力带和环扎钢丝治疗髌骨骨折106例,疗效满意。1材料与方法1.1病例资料本组106例,男64例,女42例,年龄14～70岁,骨折部位以髌骨中部为主,大多数骨折为粉碎性。髌     

克氏针固定儿童锁骨移位性骨折的疗效观察

2002年2月～2006年8月,笔者应用细克氏针对12例儿童锁骨移位性骨折进行内固定,取得满意疗效。     

改良克氏针加钢丝治疗髌骨骨折

2006年1月～2008年10月,我科共收治髌骨骨折68例,其中12例施行M形克氏针加钢丝固定治疗,疗效满意。1材料与方法1.1病例资料本组12例,男5例,女7例,年龄18～70岁。闭合骨折11例,开放骨折合并股骨干骨折1例。骨折类型：横断骨折8例,粉碎性骨折4例。1.2治疗方法连续硬膜外麻醉。采用髌骨正中直切口,将骨折复位,用点状复位钳临时固定;     

Kirschner wire migration causing spinal cord injury one year after internal fixation of a clavicle fracture

K-wire migration after internal fixation of the clavicle has rarely been reported to cause spinal cord injuries. A 30-year-old man presented with progressive paraparesis, hypaesthesia under a Th4 level and electric pain in the neck and arms. CT of the spine revealed a migrated K-wire from a one-year-old clavicle osteosynthesis, penetrating the spinal canal through the Th2 nerve root foramen, and perforating the spinal cord with a transversal trajectory. Surgical removal of the K-wire was performed after exposing both ends. Laminectomy allowed visual control of the entry point and correction of cerebrospinal fluid leakage. The pain disappeared and the patient recovered a normal gait after 6 weeks. The use of two incisions is advocated in such cases: one lateral to allow wire removal, and one medial for dural repair and early intradural bleeding control. Regular follow ups, K-wire removal after fracture healing as well as bending the wire end in a walking stick shape should minimise the risk of migration.     

外侧微型钢板及克氏针辅助固定治疗儿童肱骨远端骨干-干骺端交界性骨折

目的:探讨外侧微型钢板及克氏针辅助固定治疗儿童肱骨远端骨干-干骺端交界性骨折的手术方法及临床疗效。方法:回顾性分析自2015年1月至2018年12月收治的21例肱骨远端骨干-干骺端交界性骨折患儿,男12例,女9例;年龄2～10岁,平均4.5岁;受伤至手术时间6 h～7 d。影像学资料显示骨折线位于肱骨远端骨干-干骺端交界区域,斜形骨折10例,横形骨折8例,粉碎骨折3例。手术方式均采用切开复位外侧微型钢板及克氏针辅助内固定,采用改良Flynn肘关节评分标准进行临床疗效评价。结果:21例患儿均得到随访,时间8～24个月,平均13个月,愈合时间为6～8周,平均7.2周,术后均未出现骨折再移位、肘内翻畸形及尺神经损伤等并发症。按照改良Flynn肘关节评分标准进行评价,优19例,良2例。结论:儿童肱骨远端骨干-干骺端交界性骨折与肱骨髁上骨折治疗方法不同,采用切开复位外侧微型钢板及克氏针辅助固定治疗具有稳定性强、功能良好、并发症少的优点值得临床推广。     

双克氏针髓内固定治疗锁骨骨折

2004-2006年,我们对21例锁骨中外1／3骨折患者采用双枚克氏针髓内固定,其中部分长斜骨折再加用钢丝环扎,疗效满意。     

克氏针加不同材料环扎治疗锁骨粉碎性骨折疗效分析

2001年1月-2009年3月,我科采用克氏针加不同材料（可吸收线、钢丝、粗丝线）环扎固定蝶形骨块治疗锁骨粉碎性骨折60例,笔者对疗效进行比较。     

自制克氏针钩固定治疗严重移位儿童肱骨近端骨折

目的：探讨自制克氏针钩治疗严重移位的儿童肱骨近端骨折的临床疗效。方法：2007年1月至2012年2月,应用自制克氏针钩治疗严重移位的儿童肱骨近端骨折35例,男25例,女10例;年龄5～17岁,平均13.2岁;伤后至手术时间1～10 d,平均4.5 d.骨折移位根据Neer-Horwitz分型,Ⅲ型26例,Ⅳ型9例。均为闭合性骨折,无神经血管损伤。手术均行切开复位,复位满意后行自制克氏针钩固定。观测记录术中及术后并发症、术后放射学检查结果、上肢长度及肩关节活动度,并以Neer肩关节功能评分标准对肩关节功能进行评分。结果：35例获得随访,时间6～18个月,平均12.1个月。末次随访时肩关节功能Neer评分84～99分,平均（94.2±4.8）分,优30例,良5例;X线片显示所有病例骨性愈合,未发现内固定物松动断裂等并发症,无骨骺早闭现象,无肢体短缩畸形。除外展外患侧肩关节各方向活动度与正常侧肩关节相同（P>0.05）.所有患者能参加正常的体育活动。结论：自制克氏针钩固定是一种安全、有效的治疗严重移位的儿童肱骨近端骨折的方法。     

克氏针横形固定小儿胫骨开放性斜形骨折20例

1996～2005年,笔者采用克氏针横形固定治疗小儿胫骨开放性斜形骨折20例,效果良好. 1 材料与方法 1.1 病例资料本组20例,男12例,女8例,年龄4～13岁.均为新鲜开放性胫腓骨骨折,但胫骨折端为斜形,内外移位骨折16例,前后移位骨折4例.     

肱三头肌两侧入路克氏针钢丝内固定治疗肱骨髁上骨折

2003年5月～2007年9月,我们采用肱三头肌两侧入路克氏针钢丝内固定治疗肱骨髁上骨折116例,效果良好。     

克氏针髓内固定治疗第5掌骨颈骨折

2016 年1 月 ～2018 年12 月,我科采用克氏针髓内固定治疗12 例第5 掌骨颈骨折患者,疗效满意,报道如下. 1 材料与方法 1. 1 病例资料 本组12例,男8例,女4例,年龄18～46岁.均采用克氏针髓内固定治疗,伤后至手术时间2～3d.     

双克氏针交叉固定加粗丝线治疗锁骨粉碎骨折

2004年3月～2007年12月,笔者采用双克氏针交叉固定加粗丝线治疗锁骨粉碎骨折46例,疗效满意。1材料与方法1．1病例资料本组46例,男32例,女14例,年龄16—57岁。左侧13例,右侧33例。骨折部位：锁骨中段35例,锁骨中外1／3段11例。受伤至手术时间1～72h。     

Intraspinal migration of a Kirschner wire 3 months after clavicular fracture fixation

The authors describe a patient who had Kirschner (K-) wire osteosynthesis of a right lateral clavicular fracture and developed a tetraparesis after 3 months. Plain X-ray and CT scan showed an intraspinal migration of one K-wire through the intervertebral foramen of C5/6. The K-wire was pulled out through an opening of the wound over the right clavicle. No CSF fistula was seen. The patient recovered without any postoperative neurological deficit. Patients with K-wire osteosynthesis should be informed about the risk of dislocation and wandering and should regularly be seen in the outpatient clinic. Regular X-rays should be performed. The K-wires must be sufficiently bent at the distal end to prevent wandering into the proximal direction. The K-wires should be removed soon after 6 weeks and, in cases of dislocation and migration, as early as possible. Electronic Publication     

Intramedullary Kirschner wire (K-wire) fixation of femoral fracture in children

Purpose The aim of this study was to evaluate the efficacy of standard intramedullary Kirschner wires (K-wires) for the treatment of femoral shaft fracture in children. Methods We report the results of intramedullary K-wires nailing in 178 children with a mean age of 7.7 years (range, 4–14 years) from 2000 to 2005, retrospectively. A total of 184 diaphyseal femoral fractures were treated with both antegrade and retrograde nailing using the same principles of elastic stable intramedullary nailing (ESIN). The patients were followed for 12 months on average (range, 6–24 months). Results No major complication (limb length discrepancy >15 mm, non-union, avascular necrosis, knee joint stiffness) occurred during the observation period. All fractures healed within 7.1 weeks on average (range, 5–12 weeks). Associated injuries were seen in 16.9% of the cases. All but seven fractures were reduced by closed manipulation. Early mobilization and weight bearing was allowed. Intramedullary K-wires were removed after an average of 4.8 months (range, 3–12 months) without any complications. Conclusions In children, intramedullary fixation by using standard K-wires provides effective treatment for the diaphyseal femoral fracture that has excellent clinical results. Each intramedullary K-wire costs US $5, which adds a cost effective advantage to this method of treatment.     

改良经皮克氏针固定治疗桡骨远端骨折

目的:探讨改良经皮克氏针固定治疗桡骨远端骨折的手术方法与疗效。方法:桡骨远端骨折患者43例,男19例,女24例;年龄14~71岁,平均39岁。采用改良经皮克氏针固定法治疗,骨折复位成功后经皮打入3枚克氏针固定。其一从桡骨远折端桡侧进针,从桡骨远折端尺侧出针,克氏针继续进针穿过尺骨下端;其二从桡骨茎突斜行进针经骨折线从桡骨近折端尺侧出针,克氏针继续进针穿过尺骨;其三从桡骨近折端桡侧斜行进针经骨折线从桡骨远折端尺侧出针。结果:术后随访6~12个月,43例均获临床愈合,无骨折再移位。按Aro评定标准:优13例,良23例,可5例,差2例。结论:改良经皮克氏针固定治疗桡骨远端骨折固定牢固,损伤小,有利于骨折愈合和关节功能恢复。     

克氏针内固定治疗末节指骨撕脱性骨折

2015 年3 月 ～2018 年10 月,我科采用改良切开复位克氏针内固定治疗25 例新鲜闭合末节指骨撕脱性骨折患者,疗效满意,报道如下. 1 材料与方法 1.1 病例资料 本组25 例,男17 例,女8例,年龄21 ～58 岁.损伤指别:环指10例,小指10 例,中指3 例,示指2例.均为新鲜闭合骨性锤状指,表现为...