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目的探讨严重移位的,而且在屈曲及伸直位置均不稳定的小儿肱骨髁上骨折Gartland Ⅳ型的外科治疗。方法对2008年3月～2010年8月我院收治的8例儿童严重的GartlandⅣ型肱骨髁上骨折的手术治疗疗效进行评价,并分析此类型小儿肱骨髁上骨折手法复位失败的原因和切开复位克氏针固定的治疗效果。结果 8例Gartland Ⅲ型肱骨髁上骨折患儿均接受切开复位及克氏针内固定术,早期进行肘关节功能锻炼,总体效果良好。随访1～3年,无一例发生骨不连,肘内翻,神经损伤。结论 Gartland Ⅲ型肱骨髁上骨折切开复位仍是主要治疗手段。同时,早期进行肘关节功能锻炼,是提高本种类型骨折治疗疗效、防止肘内翻畸形发生的关键。
Objective To investigate the surgical treatment of Gartland Ⅳ type of supracondylar fractures of humerus in children with severe displacement and instability in both flexion and extension. Methods From March 2008 to August 2010 in our hospital admitted to 8 cases of severe Gartland type Ⅳ supracondylar humerus fractures of the surgical treatment of the efficacy of evaluation and analysis of this type of pediatric supracondylar fractures of the hand reduction failure reasons and incision Revised Kirschner wire fixation treatment. Results Eight cases of Gartland type Ⅲ supracondylar fractures were treated with open reduction and Kirschner wire internal fixation. The elbow joint functional exercise was performed early and the overall effect was good. Follow-up 1 to 3 years, no case of nonunion, cubitus varus, nerve injury. Conclusion Gartland Ⅲ type supracondylar fracture of the humerus is still the main treatment for open reduction and reduction. At the same time, early elbow functional exercise, is to improve the type of fracture treatment efficacy, to prevent cubitus varus deformity the key.