克氏针和拉力螺钉治疗儿童肱骨内上髁骨折疗效比较

目的：比较克氏针和拉力螺钉内固定治疗儿童肱骨内上髁骨折的临床疗效。方法：回顾分析2002年6月-2009年12月手术治疗的儿童肱骨内上髁骨折78例,克氏针组38例,均采用切开复位两枚克氏针内固定,3～4周去石膏托后开始肘关节功能锻炼;拉力螺钉组40例,均采用切开复位1枚拉力螺钉内固定,2周去石膏托后开始肘关节功能锻炼。结果：参照Mayo肘关节功能评分系统,术后3个月对肘关节功能进行评价。克氏针组：优23例,良7例,可6例,差2例,优良率为78.9%;拉力螺钉组：优30例,良8例,可2例,差0例,优良率为95.0%。2组比较差异有统计学意义（P〈0.05）,拉力螺钉组疗效明显优于克氏针组。结论：切开复位、拉力螺钉内固定结合早期功能锻炼治疗儿童肱骨内上髁骨折,能在较短时间内使患儿肘关节功能得到最大程度的恢复。

Comparison of Kirschner Wire and Lag Screw in the Treatment of Medial Humeral Epicondyle Fracture in Children

Objective: To comprise the clinical effect of Kirschner wire and lag screw internal fixation for treating medial humeral epicondyle fracture in children.Methods:We retrospectively analyzed 78 children with the medial humeral epicondyle fracture who were treated in Quanzhou osteopathy hospital from June 2002 to December 2009.The patients in Kirschner wire group(n=38) were treated by open reduction and two Kirschner wire internal fixation,elbow joint functional exercise should be conducted after 3 to 4 weeks when plaster was removed.The patients in lag screw group(n=40) were treated by open reduction and one lag screw internal fixation,elbow joint functional exercise should be conducted after 2 weeks when plaster was removed.Results:The functional of elbow joint were assessed three months after surgery according to Mayo system.There were 23 cases as excellent,8 cases as good,6 cases as fair,and 2 cases as poor in Kirschner wire group.And there were 30 cases as excellent,8 cases as good,2 cases as fair,and no cases as poor in lag screw group.The excellent and good rate was 78.9% and 95.0% respectively in the two groups(P<0.05).Conclusion:Open reduction and lag screw internal fixation combination with early function exercise are effective for humeral medial epicondyle fracture in children,which can recover elbow joint function quickly.