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目的:探讨儿童GartlandⅡ型肱骨髁上骨折的治疗策略。方法:回顾我院2005年1月-2011年12月入院治疗并得到随访的儿童GartlandⅡ型肱骨髁上骨折93例(6~12岁),按治疗方式分组,参照Flynn肘部骨折疗效评定标准,比较闭合复位石膏外固定、闭合复位内固定及切开复位内固定3种治疗方法对该骨折预后的影响。结果:93例患者中:闭合复位组20例,85%(17/20)的患者治疗效果优良。闭合复位内固定组55例及切开复位内固定组18例均取得了100%的治疗优良率。在预后的比较上:闭合复位内固定组与闭合复位石膏外固定组比较(P=0.003<0.05)差异有统计学意义,闭合复位组与切开复位组比较差异无统计学意义(P=0.091>0.05)。内固定方式上2枚克氏针与3枚克氏针固定全部取得了优良的结果。结论:“闭合复位经皮外侧2枚克氏针内固定辅以石膏外固定”是GartlandⅡ型儿童肱骨髁上骨折治疗的首选方法。
Objective: To explore the treatment strategy of Gartland Ⅱ supracondylar humerus fractures in children. Methods: Ninety-three children (6-12 years old) with Gartland type II supracondylar fractures admitted to our hospital from January 2005 to December 2011 were retrospectively reviewed. According to the evaluation criteria of Flynn elbow fracture, To compare the effects of three methods of external fixation, closed reduction and internal fixation with open reduction and internal fixation on the prognosis of the fracture. Results: Of the 93 patients, 20 patients underwent closed reduction and 85% (17/20) received excellent treatment. 55 cases of closed reduction and internal fixation group and 18 cases of open reduction and internal fixation group have achieved 100% of the excellent rate of treatment. In the comparison of prognosis, there was significant difference between closed reduction group and closed reduction plaster external fixation group (P = 0.003 <0.05), there was no significant difference between closed reduction group and open reduction group (P = 0.091 > 0.05). Internal fixation on the two Kirschner wire and three Kirschner wire fixed all achieved excellent results. Conclusion: “Closed reduction and percutaneous 2 Kirschner wire internal fixation with plaster fixation” is the first choice for the treatment of supracondylar fracture of humerus in Gartland type Ⅱ children.