张晓军 刘青超 杨金杰 王延成

摘要：目的 探讨闭合手法复位单侧双克氏针经皮固定与克氏针内外髁经皮交叉固定治疗小儿肱骨髁上骨折的中期随访疗效对比。方法：选取本院 2017 年 1 月至 2018 年 5月住院手术并行闭合手法复位的儿童肱骨髁上骨折29 例，按兩种手术方式分为 A 组（14例）与 B 组（15例），A 组患者单侧双克氏针经皮固定，B组患者克氏针内外髁经皮交叉固定。两组患者术后均予以石膏外固定。结果：术后 A 组患儿上肢负载所需时间，肘屈伸功能、前臂旋转功能、提携角、Baumann角及前倾角恢复度数与B组相比无统计学意义（P>0.05）;A 组与B 组术后肘关节功能恢复比较亦无统计学意义（z= -0.148，P = 0.883）;结论：闭合手法复位-单侧双克氏针经皮固定与克氏针内外髁经皮交叉固定治疗小儿肱骨髁上骨折在术后负载所需时间、肘屈伸、前臂旋转、提携角、Baumann角及前倾角恢复度数均无明显差异，克氏针内外髁经皮交叉固定与单侧双克氏针经皮固定相比易于发生尺神经损伤。

关键词：肱骨髁上骨折;克氏针;骨折固定术：

Closed reduction and lateral double Kirschner wire and Kirschner wire cross condylar fracture analysis of

mid-term curative effect of percutaneous fixation for the treatment of pediatric supracondylar humerus

Abstract：Objective：To compare the efficacy of closed manipulative reduction with unilateral double Kirschner wire percutaneous fixation and Kirschner wire internal and external percutaneous transcutaneous fixation for the treatment of supracondylar fracture of humerus in children. Methods：Twenty-nine children with supracondylar fractures of the humerus who underwent closed operation and closed surgery in our hospital from January 2017 to May 2018 were enrolled. They were divided into group A（14 cases）and group B（15 cases）according to two surgical methods. Patients in group A were treated with unilateral double Kirschner wire percutaneous fixation，and patients in group B were treated with percutaneous and internal fixation of Kirschner wire. Both groups of patients were treated with gypsum external fixation. Results：The time required for upper limb load in group A，elbow flexion and extension function，forearm rotation function，carrying angle，Baumann angle and anteversion angle were not significantly different from those in group B（P>0.05）. Group A and There was no significant difference in the recovery of elbow joint function between group B（z= -0.148，P = 0.883）. Conclusion：closed manipulative reduction-unilateral double Kirschner wire percutaneous fixation and Kirschner wire internal and external percutaneous transcutaneous fixation There was no significant difference in the time required for postoperative load，elbow flexion and extension，forearm rotation，carrying angle，Baumann angle and anteversion recovery in children with humeral supracondylar fracture. Percutaneous and internal fixation of Kirschner wire and unilateral double gram Needle percutaneous fixation is prone to ulnar nerve injury.

Key words：Supracondylar fractures of humerus;K-wire;Fracture fixation

肱骨髁上骨折是儿童较常见骨折之一，根据骨折分型可以选择不同的治疗方式。目前对克氏针内固定不同的手术方式存在争议。本研究旨在对比单侧双克氏针经皮固定与克氏针内外髁经皮交叉固定治疗儿童肱骨髁上骨折的中期療效进行不同方面的比较，为小儿肱骨髁上骨折选择合理手术方式提供参考。

1 临床资料与方法

1.1 一般资料 选取本院 2017 年 1 月至 2018 年 5月住院手术并行闭合手法复位的儿童肱骨髁上骨折29 例。男2……