儿童肱骨外髁Ⅱ型骨折空心钉固定与克式针固定手术的疗效比较

Effect of cannulated screw versus Kirschner wire needle fi xation on typeⅡhumeral condyle fracture in children

  • 摘要: 目的 比较空心钉固定与克式针固定对儿童肱骨外髁Ⅱ型骨折的疗效。 方法 分析我院2015年2月- 2018年1月采用手术治疗的Ⅱ型儿童肱骨外髁骨折病例28例。克氏针固定组,男童11例,女童6例,年龄2~9岁,随访时间3~6个月;空心钉内固定组,男童7例,女童4例,年龄2~8岁,随访时间3~5个月。比较两组术后肘关节功能、骨质愈合情况、术后并发症。 结果 骨折均愈合,两组肘关节功能及骨质愈合情况无统计学差异,克氏针固定术后并发症发生率为41.18%,明显高于空心钉内固定的9.09%,但差异无统计学意义。 结论 对于儿童Ⅱ型肱骨外髁骨折,克氏针固定与空心钉固定在术后愈合率、肘关节功能方面相当,克氏针固定组的术后并发症发生率高于空心钉固定组。空心钉固定需二次手术取出内固定。

     

    Abstract: Objective To investigate the effect of cannulated screw versus Kirschner wire needle fixation for children with type Ⅱ humeral condyle fracture. Methods A retrospective analysis was carried out in 28 children with lateral humeral condyle fracture undergoing orthopaedic surgery in our department from February 2015 to January 2018. Among them, there were 17 cases with Kirschner wire needle fi xation and 11 cases with cannulated screw fi xation. In the Kirschner wire fi xation group, there were 11 boys and 6 girls with age ranging from 2-9 years old, and they were followed up for 3-6 months. In cannulated screw fi xation group, there were 7 boys and 4 girls with age ranging from 2-8 years old, and they were followed for 3-5 months. The postoperative elbow function, bone healing and complications were evaluated and compared between the two groups. Results All the cases got fracture healing, and there was no statistically significant difference in the function of elbow joint and the fracture healing between the two groups. The occurrence rate of complications in Kirschner wire fi xation group was 41.18%, higher than 9.09% of cannulated screw fi xation group (P=0.099). Conclusion In children with humerus lateral condyle fracture, cannulated screw fi xation and Kirschner wire fi xation have no difference in the outcomes including elbow function and bone healing. The occurrence rate of postoperative complications of Kirschner wire fi xation is higher than that of cannulated screw fi xation. However, the cannulated screw should be removed by secondary operation.

     

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