闭合复位穿针治疗小儿肱骨髁上骨折25例分析

目的探讨小儿肱骨髁上骨折治疗方法的选择及闭合复位内固定并发症的预防。方法回顾性分析25例明显移位的小儿肱骨髁上骨折采用在C臂下闭合复位交叉克氏针治疗的临床效果。结果随访时间3—24个月，平均9个月。骨折均在6周内愈合，关节功能无限制，无明显肘内外翻畸形。1例术后尺神经支配区感觉减退，拔除克氏针后消失，无1例感染。结论移位明显的肱骨髁上骨折，复位容易，但固定及维持复位困难，手法复位石膏或夹板外固定虽是首选治疗方法，但石膏或夹板固定不牢固，易出现松动甚至可造成血管及神经损伤，而切开复位更易进一步造成软组织创伤，组织粘连，最终导致关节僵直功能障碍。本组C臂下闭合复位交叉克氏针治疗移位明显的肱骨髁上骨折避免了上述缺点，而且方法简单。

Study of Closed Reduction and Pin Fixation in Treating 25 Children with Supracondylar Fracture of Humerus

Objective To discuss the treatment selection for children with supracondylar fracture of humerus and the preventions of complication caused by close reduction and internal fixation. Methods A retrospective analysis was made to the clinical effect of dosed reduction with cross Kirschners wires under C - arm X - ray on 25 children with obvious displacement of supracondylar fracture of humerus. Result The follow - up lasted from 3 months to 24 months with the average of 9 months. ; the fractures all healed within 6 weeks with no limitation of joint function and no obvious cubitus varus and valgus deformity ; the decrease of the sensation innervated by ulnar nerve occurred in 1 ease and the sensation recovered after Kirschners wires were pulled out ; no case had infection. Conclusions For supracondylar fracture of humerus with obvious displacement,it is easy to make reduction,but the fixation and the maintenance of reduction is not easy; manual reduction with plaster or splint immobilization, though as the first - chosen method,has such shortcomings as infirm or loosening fixation of plaster or splint which may cause injury to blood vessels or nerves; open reduction may lead to further trauma to soft tissues and tissue adhesion, and to joint stiffness; the closed reduction with cross Kirschners wires under C -arm X -ray can avoid the above mentioned shortcomings and it is easy in operation.