闭合手法复位和切开复位克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折的疗效比较
摘要
目的探讨闭合手法复位克氏针固定与切开复位克氏针固定治疗GartlandⅢ型儿童肱骨髁上骨折的疗效差异。方法回顾性分析选取2015年5月—2017年5月郑州市骨科医院收治的110例GartlandⅢ型儿童肱骨髁上骨折患者,其中采用闭合手法复位克氏针内固定治疗60例,切开复位克氏针内固定治疗50例。比较两组患者的临床疗效及并发症发生率。结果闭合组和切开组相比,两组的治疗优良率分别为96.6%(55/60)、96%(48/50),组间比较无统计学差异(P>0.05)。闭合组和切开组相比,两组的并发症发生率分别为11.6%(7/60)、10%(5/50),两组间比较无统计学差异(P>0.05)。结论 GartlandⅢ型儿童肱骨髁上骨折无论采用闭合手法复位克氏针固定治疗还是采用切开复位克氏针固定治疗,均可以获得相似的临床疗效,但闭合手法复位克氏针固定创伤小,值得推广。
引文
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[15] Banerjee S,Sabui KK,Mondal J,et al.Corrective dome osteotomy using the paratricipitaI(triceps-sparing)approach for cubitus varus deformity in children[J].J Pediatr Orthop,2012,32(4):385-393.
[16] 房学武,徐启飞,赵广辉.闭合复位经皮克氏针内固定治疗儿童肱骨踝上骨折的效果[J].河南外科学杂志,2017,23(6):125-126.
[17] 郭景尧.闭合复位经皮交叉克氏针内固定治疗儿童肱骨踝上骨折的效果观察[J].河南外科学杂志,2017,23(5):121-122.
[2] Ladenhauf HN,Schaffea M,Bauer J.The displaced supracondylar humerus fracture:indications for surgery and surgical options:a 2014 update[J].Curr Opin Pediatr,2014,26(1):64-69.
[3] Bahk MS,Uma MD,Ain MC,et al.Patterns of pediatric supracondylay humerus fracture[J].J Pediatr Orthop,2008,28(5):493-499.
[4] 莫贤跃,吴东敏,蒋荣玉.闭合复位克氏针内固定治疗GartlandⅢ型儿童肱骨髁上骨折[J].1临床骨科杂志,2014,17(6):715-717.
[5] Zamzam MM,Bakarman KA.Treatment of displaced su-pracondylar humeral fractures among children:crossedversus lateral pinning[J].Injury,2009,40(6):625-630.
[6] Gartland JJ.Supracondylar fractures of the humerus[J].Med Trial Tech Q,1963,10:37-46.
[7] Leiteh K K,Kay R M,Femino J D,et a1.Treatment of multidirectionally unstable supracondylay humerus fractures in children A modified Gartland type-IV fracture[J ].J Bone Joint Surg Am,2006,88(5):980-985.
[8] Novais EN,Andrade MA,Gomes DC.The use of joustick technique facilitates closed reduction and percutaneous fixation of muhidirectionally unstable supracondylay humeral fractures in children[J].J Pediatr Orthop,2013,33(1):14-19.
[9] 杨杰,孙辽军,余贤斌,等.操纵杆技术在儿童肱骨髁上骨折闭合复位经皮穿针中的应用[J].中华小儿外科杂志,2014,35(10):737-741.
[10] 杨杰,孙辽军,杜胜虎,等.儿童肱骨髁上骨折闭合复位失败的危险因素分析[J].中华小儿外科杂志,2013,34(12):904-906.
[11] 南国新,刘国栋,覃佳强,等.前路横切口治疗儿童Gart-land m型肱骨髁上骨折[J].中华创伤杂志,2012,28(2):120-124.
[12] Babal JC,Mehlman CT,Klein G.Nerve injuries associated with pediatric supracondylar humeral fractures:a metaanalysis[J].J Pediatr Orthop,2010,30(3):253-263.
[13] Green DW,Widmann RF,Frank JS,et al.Low incidence of ulnar nerve iniury with crossed pin placement for pediatric supracondylar humerus fractures using a mini-open technique [J].J OrthopTrauma,2005,19(3):158-163.
[14] Piskin A,Tomak Y,Sen C,et al.The management of cubitus varus and valgus using the Ilizarov method[J].J Bone Joint Surg Br,2007,89(12):1615-1619.
[15] Banerjee S,Sabui KK,Mondal J,et al.Corrective dome osteotomy using the paratricipitaI(triceps-sparing)approach for cubitus varus deformity in children[J].J Pediatr Orthop,2012,32(4):385-393.
[16] 房学武,徐启飞,赵广辉.闭合复位经皮克氏针内固定治疗儿童肱骨踝上骨折的效果[J].河南外科学杂志,2017,23(6):125-126.
[17] 郭景尧.闭合复位经皮交叉克氏针内固定治疗儿童肱骨踝上骨折的效果观察[J].河南外科学杂志,2017,23(5):121-122.