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目的探讨切开复位内固定治疗GartlandⅢ型肱骨髁上骨折的疗效。方法1999年10月—2005年4月,对62例平均年龄7.5岁的患儿,应用切开复位克氏针固定治疗GartlandⅢ型肱骨髁上骨折。其中伸直尺偏型41例,伸直桡偏型18例,伸直中间型3例;无伴发血管、神经损伤和筋膜室间隔综合征。闭合性骨折47例,开放性骨折15例。结果术后56例获得随访,随访时间为6～15个月,平均11.5个月。所有骨折均获得愈合。根据Flynn标准进行疗效评价,其中优22例(占39.3%),良21例(37.5%),可9例(16.1%),差4例(7.1%)。伤后8 h内手术的优良率为89.7%,伤后8 h后手术的优良率为63.0%。直接手术治疗的优良率为90.1%,曾接受手法复位的优良率为67.7%。结论切开复位内固定治疗GartlandⅢ型肱骨髁上骨折可取得满意的疗效,是安全、有效的治疗方法。
Objective To investigate the curative effect of open reduction and internal fixation in the treatment of Gartland type Ⅲ supracondylar humerus fractures. Methods From October 1999 to April 2005, 62 patients with an average age of 7.5 years old underwent open reduction and Kirschner wire fixation for the treatment of Gartland Ⅲ supracondylar humerus fractures. Among them, 41 cases were partial deviation of extensor ruler, 18 cases of extensor radial deviation and 3 cases of straight middle type. There were no vascular, nerve injury and compartment syndrome. 47 cases of closed fractures, open fractures in 15 cases. Results 56 cases were followed up for 6 to 15 months with an average of 11.5 months. All fractures are healed. According to the Flynn criteria, 22 patients (39.3%) were excellent, 21 (37.5%) good, 9 (16.1%) fair and 4 (7.1%) poor. The excellent and good rate of operation within 8 h after injury was 89.7%, and the excellent and good rate of operation after 8 h was 63.0%. The excellent rate of direct surgical treatment was 90.1%. The excellent and good rate of manual reduction was 67.7%. Conclusion Open reduction and internal fixation for the treatment of Gartland Ⅲ supracondylar humerus fractures can achieve satisfactory results, is a safe and effective treatment.