空心钉克氏针内固定治疗儿童陈旧性肱骨外髁骨折近期疗效观察
发布时间：2018-07-20 10:31
【摘要】：目的探讨空心钉克氏针内固定对儿童陈旧性肱骨外髁骨折的手术疗效。 方法回顾性分析我科2009年10月至2012年12月收治并获完整随访的的11例肱骨外髁陈旧性骨折患儿资料，男9例，女2例，年龄2岁1个月至6岁4个月，平均4岁5个月。患儿受伤至手术时间为30～90d，平均52d。受伤初期按Milch分型，Milch型4例，Milchē型7例，肘关节功能有不同程度受限。所有患儿均切开复位后采用一枚空心钉外加两枚交叉克氏针内固定治疗。术后随访，观察骨折愈合时间及并发症的发生，术后一年采用Dhillon评分值和Baumann角评定疗效。 结果所有患者术后均获12～34个月（平均22.7个月）随访。均在术后6～8周获骨性愈合。术后一年按照Dhillon评分标准10例为优，1例为良，优良率100%，，术前患侧肘关节活动弧度平均为（90.5±27.3°），术后一年时平均为（120.1±11.8°），二者间差异有统计学意义（t=6.527，P=0.000）。术后一年所有患儿Baumann角均在正常范围（68～80°），平均（74.3±4.2°）。无一例发生术后感染、骨折延迟愈合、畸形愈合、骨不连、肘内外翻、肱骨小头缺血坏死、医源性血管神经损伤等并发症。 结论切开复位后采用一枚空心钉外加两枚交叉克氏针内固定治疗儿童陈旧性肱骨外髁骨折可达到满意复位，稳定内固定和良好的近期疗效，并发症少。
[Abstract]:Objective to investigate the effect of internal fixation of hollow nail with Kirschner's needle on old fracture of lateral condyle of humerus in children. Methods 11 cases of old fracture of lateral condyle of humerus were retrospectively analyzed from October 2009 to December 2012 in our department. There were 9 males and 2 females, aged from 2 years 1 month to 6 years 4 months, with an average of 4 years and 5 months. The time from injury to operation was 30 to 90 days (mean 52 days). In the early stage of injury, there were 4 cases of Milch type according to Milch classification and 7 cases of Milch type, and the function of elbow joint was limited to different degree. All the children were treated with one hollow nail and two cross Kirschner needles after open reduction. The time of fracture healing and the occurrence of complications were observed. Dhillon score and Baumann angle were used to evaluate the curative effect one year after operation. Results all patients were followed up for 12 ~ 34 months (mean 22.7 months). Bone healing was achieved at 6 to 8 weeks postoperatively. According to Dhillon score, 1 case was excellent and 1 case was good, and the excellent and good rate was 100%. The mean radians of elbow motion were (90.5 卤27.3 掳) before operation and (120.1 卤11.8 掳) at one year after operation. There was significant difference between the two groups (t = 6.527P 0.000). The Baumann angle was in the normal range (68 掳80 掳) and the mean value was (74.3 卤4.2 掳) one year after operation. No postoperative infection, delayed union, malunion, nonunion, cubitus varus, ischemic necrosis of the head of humerus, iatrogenic vascular and nerve injury were found. Conclusion after open reduction, one hollow nail and two cross Kirschner needles can be used to treat the old humeral lateral condylar fracture in children. The treatment can achieve satisfactory reduction, stable internal fixation and good short-term curative effect with fewer complications.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R726.8
[Abstract]:Objective to investigate the effect of internal fixation of hollow nail with Kirschner's needle on old fracture of lateral condyle of humerus in children. Methods 11 cases of old fracture of lateral condyle of humerus were retrospectively analyzed from October 2009 to December 2012 in our department. There were 9 males and 2 females, aged from 2 years 1 month to 6 years 4 months, with an average of 4 years and 5 months. The time from injury to operation was 30 to 90 days (mean 52 days). In the early stage of injury, there were 4 cases of Milch type according to Milch classification and 7 cases of Milch type, and the function of elbow joint was limited to different degree. All the children were treated with one hollow nail and two cross Kirschner needles after open reduction. The time of fracture healing and the occurrence of complications were observed. Dhillon score and Baumann angle were used to evaluate the curative effect one year after operation. Results all patients were followed up for 12 ~ 34 months (mean 22.7 months). Bone healing was achieved at 6 to 8 weeks postoperatively. According to Dhillon score, 1 case was excellent and 1 case was good, and the excellent and good rate was 100%. The mean radians of elbow motion were (90.5 卤27.3 掳) before operation and (120.1 卤11.8 掳) at one year after operation. There was significant difference between the two groups (t = 6.527P 0.000). The Baumann angle was in the normal range (68 掳80 掳) and the mean value was (74.3 卤4.2 掳) one year after operation. No postoperative infection, delayed union, malunion, nonunion, cubitus varus, ischemic necrosis of the head of humerus, iatrogenic vascular and nerve injury were found. Conclusion after open reduction, one hollow nail and two cross Kirschner needles can be used to treat the old humeral lateral condylar fracture in children. The treatment can achieve satisfactory reduction, stable internal fixation and good short-term curative effect with fewer complications.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R726.8
【参考文献】
相关期刊论文 前2条
1 吴泉州;王晓林;郑荣宗;兰树华;叶方;;空心钉治疗儿童陈旧性肱骨外髁骨折[J];临床骨科杂志;2011年03期
2 沈品泉;张菁;陈s
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