透视引导下经皮交叉k针闭合复位内固定儿童肱骨髁上延伸型Gartland ii型和iii型骨折的治疗结果

Chattagram Maa-O-Shishu Hospital Medical College Journal Pub Date : 2021-11-11 DOI:10.3329/cmoshmcj.v20i2.56470

Tafhim Ehsan Kabir, Anm Humayun Kabir, Alak Kanti Biswas, Rahmah Anwar, Touhidul Islam, Tusher Kanti Nath

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引用次数: 0

摘要

背景:肱骨髁上骨折是儿童最常见的骨折之一。治疗不当会导致骨折部位不愈合。因此，闭合复位和经皮钉钉被认为是治疗的黄金选择。有许多经皮克丝固定的方法。本研究的目的是报道使用内侧和外侧交叉钉钉经皮固定的优点。材料与方法:选取2018年1月至2020年9月在两家不同医院门诊就诊的Gartland II型和III型肱骨髁上骨折患儿共70例。所有患者均采用经皮交叉k针闭合复位内固定治疗。采用Flynn标准评估治疗结果，并与其他类似研究进行比较。结果:研究对象的平均年龄为8.14±2.8岁，男女比例为1.6:1。27例(38.6%)左臂受累，43例(61.4%)右臂受累。术前并发症包括桡神经麻痹1例(1.4%)，无脉粉手4例(5.7%)。当使用Flynn标准评估美容结果时，有57例(81.4%)为优秀，10例(14.3%)为良好，3例(4.3%)为一般。根据活动范围评定结果:优35例(50%)，良22例(31.4%)，一般5例(7.2%)，差8例(11.4%)。术后并发症为尺神经失用症1例(1.4%)，浅表针道感染5例(7.2%)。结论:大多数Gartland II型和III型肱骨髁上骨折患者采用经皮内侧和外侧交叉导线闭式复位内固定可获得满意的美观和功能效果。上海医科大学医学院;期(2);2021年7月;页面32-36

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Treatment Result Following Fluoroscopic Guided Close Reduction and Internal Fixation by Per-Cutaneous Crossed K-Wires of Extension Type Gartland Type-II and Type-III Supracondylar Fracture of Humerus in Children

Background : Supracondylar fractures of the humerus is one of the most common fractures in children. Failure to treat properly leads to malunion of the fracture site. For that, closed reduction and percutaneous pinning is considered to be the golden choice for treatment. There are many methods in which percutaneous k-wire fixation can be done. The aim of this study is to report the advantages of percutaneous fixation using cross pinning from both medial and lateral sides. Materials and methods : A total number of seventy pediatric patients with Gartland type II and type III supracondylar fracture of the humerus were recruited from the outpatient department of two different hospitals between January 2018 and September 2020. All of them were treated using closed reduction and internal fixation using percutaneous crossed k-wires. The treatment outcomes were evaluated using Flynn’s criteria and were compared with other similar studies. Results : The mean age of study subjects was 8.14 ± 2.8 and the male to female ratio was 1.6:1. In 27(38.6%) cases the left arm was involved while in 43(61.4%) cases the right arm was involved. Preoperative complications included 1(1.4%) case with radial nerve palsy and 4(5.7%) cases with pulseless pink hand. When evaluating cosmetic outcome using Flynn’s criteria, there were 57(81.4%) excellent, 10(14.3%) good and 3(4.3%) fair outcomes. On evaluating outcome according to range of motion deficit outcomes were excellent in 35(50%), good in 22(31.4%), fair in 5(7.2%) and poor in 8(11.4%) children. Post-operative complications were 1(1.4%) ulnar nerve neuropraxia and 5(7.2%) superficial pin tract infections. Conclusion : Closed reduction and internal fixation using percutaneous crossed kwires placed from the medial and lateral side gives satisfactory cosmetic and functional outcomes in majority of the patients with Gartland type II and III supracondylar fractures of the humerus. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 32-36

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Chattagram Maa-O-Shishu Hospital Medical College Journal

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