目的 比较克氏针和无头全螺纹空心钉内固定治疗Jacob Ⅲ型肱骨外髁骨折的疗效。方法 选取2017-01至2023-12在解放军总医院第七医学中心小儿骨科就诊的肱骨外髁骨折患者34例,所有患者均采用切开复位,其中18例克氏针固定(克氏针组),16例无头全螺纹空心钉固定(空心钉组)。比较两组术后骨折愈合情况、术后并发症,采用Mayo评分标准评估术后肘关节功能。结果 两组均达到良好的骨性愈合,肘关节功能评分差异无统计学意义。术后并发症方面,克氏针组发生肘关节外侧突起12例(66.67%),空心钉组4例(25.00%),差异有统计学意义(P=0.037)。克氏针组出现5例皮肤感染及7例克氏针松动,空心钉组有1例皮肤感染,未见螺钉松动。克氏针组4例肘关节伸直<10 °,空心钉组发生3例,差异无统计学意义。结论 克氏针及无头全螺纹空心钉固定治疗JacobⅢ型肱骨外髁骨折,均有良好的临床效果。无头空心钉可以通过稳定的骨折固定,促进骨折愈合及肘关节功能恢复,并且减少肘关节外侧突起概率。
Abstract
Objective To compare the efficacy of K-wire and headless fully threaded cannulated screws in the treatment of Jacob Ⅲ lateral humeral condyle fracture. Methods A total of 34 patients with lateral condyle humerus fractures who were treated in the Pediatric Orthopedics Department of the Seventh Medical Center of PLA General Hospital from January 2017 to December 2023 were selected. All patients underwent open reduction, with 18 cases fixed with Kirschner wires(K-wire group) and 16 cases fixed with headless fully threaded cannulated screws(screw group). The postoperative fracture healing and complications were compared between the two groups, and the postoperative elbow joint function was evaluated by Mayo scoring system. Results Both groups achieved good bone healing, with no statistically significant difference in elbow joint function scores. In terms of postoperative complications, 12 cases in the K-wire group had lateral protrusion of the elbow joint, while 4 cases in the screw group, with statistically significant difference between the two groups (P=0.037). The K-wire group had 5 cases of skin infection and 7 cases of loosening of Kirschner wires, whereas the screw group had one case of skin infection and no loosening observed. Four cases in the K-wire group had elbow extension less than <10°, while three cases occurred in the screw group, with no statistically significant difference. Conclusions Kirschner wire and headless fully threaded hollow screws are both effective in treating Jacob III lateral humeral condyle fracture, showing good clinical outcomes. Headless hollow screws can promote fracture healing and elbow joint function recovery through stable fracture fixation, and reduce the probability of lateral elbow protrusion.
关键词
肱骨外髁骨折 /
手术 /
切开复位 /
克氏针 /
螺钉
Key words
lateral humeral condyle fracture /
surgery /
open reduction /
Kirschner wire /
cannulated screw
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参考文献
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基金
军队某课题资助,国家自然科学基金(81702169)
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