[1]苏联彬 王承云 刘琦△ 王斯晟 陈永法 刘茂升 李楠竹.单纯外侧克氏针固定治疗儿童肱骨髁上骨折稳定性及神经损伤情况分析[J].中国中医骨伤科杂志,2022,30(04):72-75.
　SU Lianbin WANG Chengyun LIU Qi WANG SishengCHEN Yongfa LIU Maosheng LI Nanzhu.Analysis of Stability and Nerve Injury of Humeral Supracondylar Fracture in Children Treated with Lateral Kirschner Wire Fixation Alone[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(04):72-75.
点击复制

单纯外侧克氏针固定治疗儿童肱骨髁上骨折稳定性及神经损伤情况分析()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年04期
页码:
72-75
栏目:
临床报道
出版日期:
2022-04-15

文章信息/Info

Title:
Analysis of Stability and Nerve Injury of Humeral Supracondylar Fracture in Children Treated with Lateral Kirschner Wire Fixation Alone
文章编号:
1005-0205(2022)04-0072-04
作者:
苏联彬1 王承云1 刘琦1△ 王斯晟1 陈永法1 刘茂升1 李楠竹1
1厦门大学附属第一医院小儿骨科(福建 厦门,361003)
Author(s):
SU Lianbin1 WANG Chengyun1 LIU Qi1△ WANG Sisheng1CHEN Yongfa1 LIU Maosheng1 LI Nanzhu1
1Department of Pediatric Orthopedics,The First Affiliated Hospital of Xiamen University,Xiamen 361003,Fujian China.
关键词:
肱骨髁上骨折; 手法复位; 骨折稳定性; 神经损伤
Keywords:
supracondylar fracture of humerus;  closed reduction;  fracture stability;  nerve injury
分类号:
R683.41
文献标志码:
B
摘要:
目的:探讨分析单纯外侧克氏针固定治疗儿童肱骨髁上骨折稳定性及神经损伤情况。方法:回顾2018年9月至2021年2月因肱骨髁上骨折收治本科手术治疗病例(共113例),记录分析患儿年龄,性别,侧别,骨折分型,患肢神经损伤情况,末次随访肘关节功能; 比较术后1 d、术后2个月Baumann角。结果:共113例闭合复位成功,无切开病例,其中110例成功获得随访。术后发生桡神经损伤1例,无尺神经损伤,无肘内翻病例发生,术后第1天与术后2个月Baumann角对比(74.51°±4.12° vs 73.87°±3.62°),差异无统计学意义(P>0.05)。根据改良Flynn标准进行评定,所有病例术后6个月随访时均活动,优102例,良8例。结论:手法复位结合单纯外侧克氏针固定治疗儿童肱骨髁上骨折,操作简单,在避免医源性神经损伤的同时,能提供足够的稳定性,是一项可靠、安全的技术。
Abstract:
Objective:To investigate the stability and nerve injury of children humerus supracondylar fracture treated with closed reduction and lateral Kirschner wire fixation.Methods:A total of 113 cases of supracondylar fracture of humerus from September 2018 to February 2021 were reviewed.The age,sex,side,classification of fracture,nerve injury of the limb and elbow function at the last follow-up was recorded and analyzed; Baumann angle was examined 1 d and 2 months after surgery.Results:There were 113 cases closed successfully,none of which were incised,and 110 of them were successfully followed up.There was 1 case of radial nerve injury after surgery,and no ulnar nerve injury or cubital varus occurred.Baumann’s comparison between 1 d and 2 months after surgery showed no statistical significance(74.51°±4.12° vs 73.87°±3.62°,P>0.05).According to the modified Flynn criterion,102 cases were excellent,and 8 cases were good at 6 months follow-up.Conclusion:The closed reduction combined with percutaneous lateral Kirschner wire fixation on the treatment of children humerus supracondylar fracture is a reliable and safe technique with high success rate of closed reduction and simple operation,which can provide sufficient stability while avoiding iatrogenic nerve injury.

参考文献/References:

[1] AHMED SHAWKAT RIZK, MAHMOUD IBRAHIM KANDIL.Conventional versus lateral cross-pinning(dorgan’s technique)for fixation of displaced pediatric supracondylar humeral fractures:a randomized comparative study[J].The Egyptian Orthopaedic Journal,2018,53(4): 348-358.
[2] GATTU A,BABU B K.Percutaneous pinning in displaced supracondylar fracture of humerus in children[J].Int J Otrh Sci,2017,3(3):156-160.
[3] NA Y,BAI R,ZHAO Z,et al.Comparison of lateral entry with crossed entry pinning for pediatric supracondylar humeral fractures:a meta-analysis[J].Journal of Orthopaedic Surgery and Research,2018,13(1):68.
[4] 王斯晟,李楠竹,刘琦,等.闭合复位经皮穿针治疗改良GartlandⅣ型儿童肱骨髁上骨折的疗效分析[J].中国全科医学,2020,23(S2):107-109.
[5] AFAQUE S F,SINGH A,MAHARJAN R,et al.Comparison of clinic-radiological outcome of cross pinning versus lateral pinning for displaced supracondylar fracture of humerus in children:a randomized controlled trial[J].Journal of Clinical Orthopaedics and Trauma,2020,11(2):259-263.
[6] SHENOY P M,ISLAM A,PURI R.Current management of paediatric supracondylar fractures of the humerus[J].Cureus,2020,12(5):e8137.
[7] 梁勇,江平频,张新武,等.屈肘位牵引摇摆复位手法结合克氏针内固定治疗儿童肱骨髁上骨折32例[J].中国中医骨伤科杂志,2021,29(5):62-65.
[8] DUI S,RADLOVI V,BUKVA B,et al.A prospective randomised non-blinded comparison of conventional and Dorgan’s crossed pins for paediatric supracondylar humeral fractures[J].Injury,2016,47(11):2479-2483.
[9] LEITCH K K,KAY R M,FEMINO J D,et al.Treatment of multidirectionally unstable supracondylar humeral fractures in children.a modified gartland type-IV fracture[J].The Journal of Bone and Joint Surgery:American Volume,2006,88(5):980-985.
[10] 樊燕华,汤小康,童培建.儿童肱骨髁上骨折移位程度与Baumann角关系的分析研究[J].中国骨伤,2013,26(2):95-97.
[11] CANALES-ZAMORA O A,MORA-R OS F G,MEJ A-ROHENES L C,et al.Complications of supracondylar humeral fractures in children[J].Acta Ortopedica Mexicana,2020,34(2):91-95.
[12] REISOGLU A,KAZIMOGLU C,HANAY E,et al.Is pin configuration the only factor causing loss of reduction in the management of pediatric type Ⅲ supracondylar fractures?[J].Acta Orthopaedica et Traumatologica Turcica,2017,51(1):34-38.
[13] KOCHER M S,KASSER J R,WATERS P M,et al.Lateral entry compared with medial and lateral entry pin fixation for completely displaced supracondylar humeral fractures in children.A randomized clinical trial[J].The Journal of Bone and Joint Surgery:American Volume,2007,89(4):706-712.
[14] PRASHANT K,LAKHOTIA D,BHATTACHARYYA T D,et al.A comparative study of two percutaneous pinning techniques(lateral vs medial-lateral)for Gartland type Ⅲ pediatric supracondylar fracture of the humerus[J].Journal of Orthopaedics and Traumatology:Official Journal of the Italian Society of Orthopaedics and Traumatology,2016,17(3):223-229.
[15] PENNOCK A T,CHARLES M,MOOR M,et al.Potential causes of loss of reduction in supracondylar humerus fractures[J].Journal of Pediatric Orthopedics,2014,34(7):691-697.
[16] KESEMENLI C.Biomechanical analysis of percutaneous all lateral pinning(Dorgan’s technique)technique for supracondylar humerus fractures in children[J].Journal of Biomechanics,2011,44(1):10.
[17] LEE S S,MAHAR A T,MIESEN D,et al.Displaced pediatric supracondylar humerus fractures:biomechanical analysis of percutaneous pinning techniques[J].Journal of Pediatric Orthopaedics,2002,22(4):440-443.
[18] EL-ADL W A,EL-SAID M A,BOGHDADY G W,et al.Results of treatment of displaced supracondylar humeral fractures in children by percutaneous lateral cross-wiring technique[J].Strategies in Trauma and Limb Reconstruction,2008,3(1):1-7.
[19] MEMISOGLU K,CEVDET KESEMENLI C,ATMACA H.Does the technique of lateral cross-wiring(Dorgan’s technique)reduce iatrogenic ulnar nerve injury?[J].International Orthopaedics,2011,35(3):375-378.
[20] WOO C Y,HO H L,ASHIK M B Z,et al.Paediatric supracondylar humeral fractures:a technique for safe medial pin passage with zero incidence of iatrogenic ulnar nerve injury[J].Singapore Medical Journal,2018,59(2):94-97.

备注/Memo

备注/Memo:
基金项目:福建中医药大学校管临床专项课题(XB2021094)
△通信作者 E-mail:597029416@qq.com
更新日期/Last Update: 1900-01-01