切开复位交叉克氏针内固定术治疗难复性肱骨远端全骺分离26例

目的对26例难复性肱骨远端全骺分离患者行切开复位内固定术后的临床疗效进行观察。方法以四川省骨科医院儿童骨科2015年1月至2017年7月收治的26例肱骨远端全骺分离患者为研究对象,26例均在全身麻醉联合臂丛麻醉下行轻柔闭合复位,均未达到满意复位,后立即行肘外侧切开复位交叉克氏针内固定术,术后3周取除石膏外固定行伤肢主动功能锻炼。术后采用Flynn肘关节功能评定标准评定疗效。结果本组26例均获随访,随访时间8个月至3年6个月,平均2年1个月,疗效判定等级:优19例,良5例,一般2例,差0例;优良率达92%。结论儿童难复性肱骨远端全骺分离行切开复位交叉克氏针内固定术可最大程度获得解剖复位,术后肘内翻发生率低,伤肢肘关节功能活动恢复良好。

Clinical efficacies of open reduction plus internal fixation of cross Kirschner wire for difficult-to-reduce distal humeral epiphysis separations

Objective To explore the clinical efficacy of open reduction plus internal fixation of cross Kirschner wire for difficult-to-reduce distal humeral physeal separation in children.Methods A total of 26 cases were recruited from our emergency clinic from January 2015 to July 2017.After failing to achieve satisfactory reduction by gentle closed reduction under general anesthesia plus preoperative brachial plexus anesthesia,all of them immediately underwent open reduction plus internal fixation of cross Kirschner wire via a lateral approach.At 3 weeks post-operation,plaster was removed and followed by active functional exercises.Results During an average follow-up period of 25(8-42)months,the Flynn criteria were employed for evaluating clinical efficacy.The outcomes were excellent(n=19),decent(n=5),fair(n=2)and poor(n=0).The excellent and decent rate was 92%.Conclusion Through open reduction and internal fixation of cross Kirschner wire,hard-to-reduce distal humeral physeal separations may be treated satisfactorily with maximal anatomical reduction,lower cubitus varus rate and excellent recovery of elbow function.