内外髁三针固定治疗儿童肱骨髁上骨折中尺神经损伤的预防

目的：探讨内外髁三针交叉固定治疗儿童肱骨髁上骨折尺神经损伤的预防。方法：81例儿童肱骨髁上骨折，男54例，女27例；年龄2．5～11岁，平均6岁。根据Gartland分型：Ⅱ型25例，Ⅲ型56例。采用内外髁三针交叉固定方法治疗，患者均闭合复位内外髁三针交叉固定，术后石膏托固定3周。结果：81例获得随访，患者术后均获得即时稳定性和远期骨性愈合，均未出现医源性尺神经损伤，肘关节功能均获得满意恢复。结论：内外髁三针交叉固定术是一种稳定而可靠的治疗不稳定髁上骨折方法，术中尺神经损伤完全可以避免。

Prevention of ulnar nerve injury during fixation of supracondylar fractures in children by a medial-lateral three-pin fixation technique

Objeclive：To expore the prevention of ulnar nerve injury during fixation of supracondylar fracture in children by a medial-lateral three-pin fixation technique. Methods：Eighty-one patients including 54 boys and 27 girls with average age of 6 years old （2.5 to 11 years）were treated by a three-pin fixation technique with insertion of two Kirscher wires from the lateral side and the third wire through the medial side. They were followed-up without any complications related to the ulnar nerve. According to Garland system,there were 25 cases of type II supracondylar fracture and 56 of type ~[. All patients were treated by a medial-lateral three-pin fixation technique, and external fixation with plaster for 3 weeks. Results ： All cases achieved im- mediate stability and long-term bony fusion postoperatively and no iatrogenic ulnar nerve injury happen. Conclusion ：The technique is a stable and reliable methods for unstable supracondylar fracture and the iatrogenic injury ulnar nerve can be avoided completely.