肘关节镜下复位经皮内固定治疗儿童肱骨外髁骨折

目的肘关节镜下复位经皮内固定治疗儿童肱骨外髁骨折的疗效。方法将64例肱骨外髁骨折患儿按入院先后顺序分为两组:切开复位组32例,采用切开复位内固定治疗;关节镜组32例,采用肘关节镜下复位经皮内固定治疗。结果 64例患儿术后获得12~24个月的随访,平均17.15±5.12个月。关节镜组及切开复位组术中出血量分别为40.5±8.5 mL、110.5±15.5 mL;切口长度分别为0.95±0.30 cm、6.95±1.50 cm;术后第3天视觉模拟疼痛评分(VAS)分别为3.85±1.35、7.85±2.05分,两组间差异有统计学意义。根据Mayo肘关节功能评分切开复位组优良率为84.4%,关节镜组优良率为96.9%,两组间差异有统计学意义。术后切开复位组肘关节内外翻畸形3例,钉道感染5例;关节镜组只有1例肘关节内外翻畸形,没有钉道感染病例。两组间术后并发症差异有统计学意义。结论肘关节镜下复位经皮内固定治疗儿童肱骨外髁骨折具有创伤小、并发症少等优点。

Elbow arthroscopy-assisted reduction and percutaneous fixation for treatment of the humeral lateral condyle fracture in children

［Abstract］ Objective To investigate the effect of the treatment of the humeral lateral condylefracture in children under Elbow arthroscopy. Methods Sixty?four cases of the humeral lateral condyle fracture were randomly divided into open reduction group and arthroscopy group，each group of 32 cases. Results All the 64 patients were followed up for 12?24 months postoperatively，with average of 17.15±5.12 months. The amount of bleeding in the arthroscopy group and the open reduction group was 40.5±8.5 ml and 110.5 ± 15.5 ml，the length of incision was 0.95 ± 0.30 cm and 6.95 ± 1.50 cm，and the visual analogue pain score （VAS） was 3.85 ± 1.35 and 7.85 ± 2.05 respectively on the third day after the operation，and the differences were statistically significant. According to Mayo score，the total fine rate was 84.4% in the open reduction group and 96.9% in the arthroscopy group，and the difference between the two groups was statistically significant. In the open reduction group，there were 3 cases of elbow joint varus deformity，5 cases of nail path infection. However there were one case of elbow joint varus deformity in arthroscopy group. There was a statistically significant difference in postoperative complications between the two groups. Conclusion Arthroscopic reduction and percutaneous internal fixation for the treatment of humeral lateral condyle fractures in children has advantages of less trauma and fewer complications.