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目的观察分级治疗模式对儿童肱骨髁上骨折的疗效。方法对56例儿童肱骨髁上骨折治疗方案分为三级。其中GartlandⅠ型6例,GartlandⅡ型19例,GartlandⅢ型31例,其中屈曲型2例,伴有神经损伤2例,患肢肿胀特别严重者2例。对GartlandⅠ型骨折,单纯应用石膏外固定;GartlandⅡ型和GartlandⅢ型骨折,首选闭合复位、经皮穿针内固定;闭合复位、经皮穿针失败者或伴有明显血管、神经损伤症状者以及患肢肿胀特别严重者,给予切开复位克氏针内固定。结果 56例随访18～29个月,平均20.6个月,按Flynn功能评价标准,优42例,良13例,差1例。结论对儿童肱骨髁上骨折采取分级治疗模式能够取得很好疗效,有效减少并发症的发生。
Objective To observe the effect of grading therapy on supracondylar humerus fractures in children. Methods Fifty-six children with supracondylar humerus fractures were divided into three levels. Gartland type I 6 cases, Gartland type 19 19 cases, Gartland type III 31 cases, including 2 cases of flexion type, with nerve injury in 2 cases, particularly severe limb swelling in 2 cases. Gartland type I fracture, simple plaster external fixation; Gartland type II and Gartland type Ⅲ fracture, the preferred closed reduction, percutaneous needle fixation; closed reduction, percutaneous needle failure or with obvious vascular, nerve injury and those with symptoms Extremities swelling particularly serious, given open reduction Kirschner wire fixation. Results 56 cases were followed up for 18-29 months with an average of 20.6 months. According to the Flynn function evaluation criteria, there were 42 cases of excellent results, 13 cases of good results and 1 case of poor results. Conclusion Adopting grading treatment for children with supracondylar humerus fractures can achieve a good curative effect and effectively reduce the incidence of complications.