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目的探讨改良外固定架治疗儿童肱骨外科颈骨折的可行性及疗效。方法 2005年3月-2010年12月对21例肱骨外科颈骨折的儿童患者采用微创切口复位改良外固定架固定术。患儿术前均摄肩关节正位X线片及CT扫描三维重建,均为不稳定型骨折。男15例,女6例;年龄6～15岁。其中闭合骨折18例,开放骨折3例。术后复查X线了解骨折愈合情况,并根据Neer功能评分系统评定恢复情况。结果术后随访6个月～3 a。术后6～8周骨折愈合,术后2个月去除外固定架。Neer功能评分,优16例,良5例,优良率100%。肩关节功能均在术后3～4周基本恢复正常,骨骺发育未见异常。2例随访至17岁,患侧肢体未见发育畸形和肢体短缩。结论近端克氏针替代螺钉,可避免损伤骨骺,小切口骨折解剖复位辅以外固定架固定治疗儿童肱骨外科颈骨折疗效满意。
Objective To investigate the feasibility and efficacy of modified external fixator in the treatment of surgical neck fracture of humerus in children. Methods From March 2005 to December 2010, 21 children with humerus neck fractures were treated with minimally invasive incision reduction and modified external fixator. Preoperative children were photographed orthopedic shoulder X-ray and CT scan three-dimensional reconstruction, are unstable fractures. 15 males and 6 females; aged 6 to 15 years. Among them, 18 cases were closed fractures and 3 cases were open fractures. Postoperative X-ray examination of fracture healing, and according to Neer function scoring system to assess the recovery. Results The patients were followed up for 6 months to 3 years. Fractures healed 6 to 8 weeks after operation, and external fixators were removed 2 months after operation. Neer function score, excellent in 16 cases, good in 5 cases, excellent and good rate of 100%. Shoulder joint function in the 3 to 4 weeks after the basic return to normal, no abnormal epiphyseal development. Two cases were followed up to 17 years old. There was no developmental malformations and limb shortening in the affected limbs. Conclusions Proximal Kirschner wire replacement screws can prevent the injury of the epiphyseal. The anatomical reduction of small incision fractures combined with external fixator fixation for surgical neck fracture of humerus in children is satisfactory.