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目的:探讨GartlandⅢ型儿童肱骨髁上骨折的治疗策略。方法:回顾分析我院2005年1月-2011年12月入院治疗,年龄在7~11岁之间并得到随访的儿童GartlandⅢ型肱骨髁上骨折168例,按治疗方式进行分组,参照Flynn肱骨髁上骨折疗效评定标准,比较闭合复位、闭合复位内固定及切开复位内固定3种治疗方法对该骨折预后的影响。结果:168例患者中,闭复组13例、闭复内固定组67例、切复组88例。参照Flynn评定标准,在预后的比较上:闭复内固定组好于闭复组(P=0.015<0.05,χ2=5.923);切复组CR优于闭复组(P=0.0039<0.05,χ2=4.262);闭复内固定组与切复组间比较差异无统计学意义(P=0.552>0.05,χ2=0.354)。结论:对于GartlandⅢ型肱骨髁上骨折,在保证复位的前提下治疗上应首选闭合复位经皮克氏针内固定。
Objective: To investigate the treatment of supracondylar humerus fractures in Gartland type III children. Methods: A retrospective analysis of our hospital from January 2005 -2011 in December admitted to hospital for treatment, aged 7 to 11 years old and follow-up of children with Gartland Ⅲ type humeral fractures in 168 cases, according to the treatment group, refer to the Flynn humeral condyle On fracture evaluation criteria, compare closed reduction, closed reduction and internal fixation with open reduction and internal fixation of three kinds of treatment of the prognosis of the fracture. Results: Among the 168 patients, there were 13 cases in the closed group, 67 cases in the closed internal fixation group and 88 cases in the resection group. According to the Flynn evaluation criteria, the prognosis was better than that of the closure group (P = 0.015 <0.05, χ2 = 5.923) = 4.262). There was no significant difference between the closed internal fixation group and the resection group (P = 0.552> 0.05, χ2 = 0.354). Conclusion: For Gartland type Ⅲ supracondylar humerus fractures, closed reduction and percutaneous Kirschner wire internal fixation should be the first choice for the treatment.