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闭合复位穿针治疗小儿肱骨髁上骨折25例【摘要】目的探讨小儿肱骨髁上骨折治疗方法的选择及闭合复位内固定并发症的预防。方法回顾性分析25例明显移位的小儿肱骨髁上骨折采用在c臂下闭合复位交叉克氏针治疗的临床效果。结果随访时间3~24个月平均9个月。骨折均在6周内愈合关节功能无限制无明显肘内外翻畸形。1例术后尺神经支配区感觉减退拔除克氏针后消失无1例感染。结论移位明显的肱骨髁上骨折复位容易但固定及维持复位困难手法复位石膏或夹板外固定虽是首选治疗方法但石膏或夹板固定不牢固易出现松动甚至可造成血管及神经损伤而切开复位更易进一步造成软组织创伤组织粘连最终导致关节僵直功能障碍。本组c臂下闭合复位交叉克氏针治疗移位明显的肱骨髁上骨折避免了上述缺点而且方法简单。【关键词】肱骨髁上骨折;经皮克氏针固定;儿童;闭合复位studyofclosedreductionandpinfixationintreating25childrenwithsupracondylarfractureofhumerusdingjinganyudongyuezhenghuaxiaoxinyuelijinguangkunminggeneralhospitalofchengdumilitarycommandkunmingyunnanprovince650032abstractobjectivetodiscussthetreatmentselectionforchildrenwithsupracondylarfractureofhumerusandthepreventionsofcomplicationcausedbyclosereductionandinternalfixation.methodsaretrospectiveanalysiswasmadetotheclinicaleffectofclosedreductionwithcrosskirschnerswiresunderc-armx-rayon25childrenwithobviousdisplacementofsupracondylarfractureofhumerus.resultthefollow-uplastedfrom3monthsto24monthswiththeaverageof9months.;thefracturesallhealedwithin6weekswithnolimitationofjointfunctionandnoobviouscubitusvarusandvalgusdeformity;thedecreaseofthesensationinnervatedbyulnarnerveoccurredin1caseandthesensationrecoveredafterkirschnerswireswerepulledout;nocasehadinfection.conclusionsforsupracondylarfractureofhumeruswithobviousdisplacementitiseasytomakereductionbutthefixationandthemaintenanceofreductionisnoteasy;manualreductionwithplasterorsplintimmobilizationthoughasthefirst-chosenmethodhassuchshortcomingsasinfirmorlooseningfixationofplasterorsplintwhichmaycauseinjurytobloodvesselsornerves;openreductionmayleadtofurthertraumatosofttissuesandtissueadhesionandtojointstiffness;theclosedreductionwithcrosskirschnerswiresunderc-armx-raycanavoidtheabovementionedshortcomingsa