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。

Lateral mini plate and Kirschner wire assisted fixation for the treatment of distal humeral metaphyseal junction fracture in children

Objective: To explore the operative method and clinical effect of lateral mini plate and Kirschner wire in the treatment of distal humeral metaphysis junction fracture in children. Methods: From January 2015 to December 2018,21 cases of distal humeral diaphyseal metaphyseal junction fracture were analyzed retrospectively,including 12 males and 9 females,aged 2 to 10 years with an average age of 4.5 years,and the time from injury to operation was 6 hours to 7 days. The imaging data showed that the fracture line was located at the junction of the distal humerus and metaphysis. There were 10 oblique fractures,8 transverse fractures and 3 comminuted fractures. The operation methods were open reduction,lateral mini plate and Kirschner wire assisted internal fixation,and the improved Flynn elbow joint scoring standard was used to evaluate the clinical effect. Results: All the 21 children were followed up for 8 to 24 months,with an average of 13 months. The healing time was 6 to 8 weeks,with an average of 7.2 weeks. There were no complications such as fracture displacement,cubitus varus and ulnar nerve injury. According to the improved Flynn elbow joint scoring standard,19 cases were excellent and 2 cases were good. Conclusion: The treatment of distal humeral metaphyseal junction fracture in children is different from that of supracondylar fracture of humerus.