克氏针交叉固定治疗复杂性肱骨髁上骨折

目的:回顾性地研究3根克氏针交叉固定闭合复位后的复杂性肱骨髁上骨折的疗效。方法:复杂性肱骨髁上骨折患者行闭合性手法复位,在透视机监视下,在肱骨髁外侧用两根克氏针固定,然后在内侧交叉固定1根克氏针。外侧固定的克氏针可以根据稳定的需要,两根克氏针可以是平行的也可以是不平行的。固定内侧克氏针时,须在保护骨折不移位的情况下小心地伸直肘关节可以保护好尺神经。术后长臂石膏维持肘关节制动3~4周。结果:所有患者在术后均未出现医源性尺神经损伤。48例患者中46例美观和功能评价均为良好,95.8%是满意的。结论:复杂移位的肱骨髁上骨折,用3根克氏针交叉固定疗效良好。

Treatment of Complex Displaced Supracondylar Fracture of the Humerus by Cross-Fixation with Three Kirschner Wires

Objective:To investigate the therapeutic efficacy of cross-fixation with three Kirschner wires in the patients with complex displaced supracondylar fracture(type 3) of the humerus.Methods:All fractures were reduced and fixed by inserting two Kirschner wires in the lateral side,followed by one crossed medial Kirschner wire under fluoroscopic guidance.Lateral pins were inserted in parallel or divergent fashion to ensure stability.With a medial crossed pin insertion,the elbow was carefully extended for easy palpation and protection of the ulnar nerve without displacing the reduced fracture.Results:There was no iatrogenic ulnar nerve injury caused by the Kirschner wires.Forty-six(95.8%)of the 48 patients showed a "satisfactory" result.Conclusion:Cross fixation with three Kirschner wires should be cosidered as an effective method in the treatment of a complex displaced supracondylar fracture of the humerus.