目的 观察闭合复位内固定治疗Gartland Ⅱ型肱骨髁上骨折的临床疗效。方法 选取收治的Gartland Ⅱ型肱骨髁上骨折患者80例,根据治疗方法不同对照原则平均分为两组,观察组40例行闭合复位内固定治疗,对照组40例行切开复位内固定治疗,比较两组患者的临床治疗效果,以Flynn肘关节功能评价标准评价两组治疗的优良率,对比两组肘功能屈伸活动度和并发症情况。结果 观察组按照Flynn肘关节功能评价标准,优31例(77.5%),良4例(10.0%),一般4例(10.0%),差1例(2.5%),优良率87.5%;对照组优32例(80.0%),良5例(12.5%),一般3例(7.5%),优良率92.5%;观察组优良率略低于对照组,但经统计学分析无明显差异(χ²=0.1389,P=0.7094)。观察组肘功能屈伸活动度、提携角与对照组相比,均无统计学差异(P>0.05)。对照组并发症发生率略高于观察组,但差异不具有统计学意义(P>0.05)。结论 闭合复位内固定治疗Gartland Ⅱ型肱骨髁上骨折具有较好的临床效果,且术后并发症少,不容易感染,不遗留手术瘢痕,值得进一步推广。

Objective To observe the clinical effect of closed reduction and internal fixation on Gartland II supracondylar fracture of humerus.Methods Eighty cases of Gartland II supracondylar humerus fracture were divided into two groups according to different treatment methods: an observation group (40 cases) receiving closed reduction and internal fixation and a control group (40 cases) receiving open reduction and internal fixation. Clinical effects were compared between the two groups. The excellent-and-good rate of treatment was evaluated by Flynn elbow function evaluation criteria.Elbow function flexion and extension activity and complications were compared between the two groups.Results In the observation group, 31 cases (77.5%) were excellent, 4 cases (10.0%) were good, 4 cases (10.0%) were fair, and 1 case (2.5%) was bad by Flynn elbow function evaluation criteria, and the excellent-and-good rate of treatment was 87.5%. In the control group, 32 cases (80.0%) were excellent, 5 cases (12.5%) were good, and 3 cases (7.5%) were fair, and the excellent-and-good rate of treatment was 92.5%. The the excellent-and-good rate of treatment in observation group was lower but not significantly than that in the control group (χ²=0.1389, P=0.7094). Elbow function flexion and extension activity and carrying angle were not significantly different betweent the two groups (P>0.05).The incidence rate of complications in the control group was slightly higher than that in the observation group, but there was no significant difference (P>0.05).Conclusion Closed reduction and internal fixation of Gartland II supracondylar humerus fracture shows good clinical effects with less complications, infections, and scars, deserving further promotion.