中文摘要：

目的探讨小切口克氏针内固定术治疗儿童肱骨髁间骨折的可行性和临床疗效。方法2005年1月至2010年9月，四川大学华西医院小儿外科共收治22例儿童肱骨髁间骨折患儿，其中男16例，女6例；年龄1～11岁，平均5．5岁。左侧13例，右侧9例。运动伤15例，车祸伤3例，高处坠落伤3例，地震伤1例。骨折分型按照Riseborough—Radin标准，其中Ⅱ型12例，Ⅲ型8例，Ⅳ型2洌，均为闭合骨折。合并其他部位骨折10例，桡神经损伤5例，尺神经损伤1例，血管损伤1例，前臂骨筋膜室综合征3例。受伤至入院时间1h至7d。均采用小切13克氏针内固定术，并同期行神经、血管探查修复治疗。结果术后切口均Ⅰ期愈合，无相关并发症发生。16例术后X线片显示骨折解剖复位，6例有轻度移位。20例获随访，随访时间6个月至3年，平均12个月。X线片显示骨折均愈合，愈合时间2～4个月，平均3个月。3例发生肘内翻，但肘关节屈伸功能基本正常，继续功能锻炼并随访观察。参照Flynn临床功能评定标准进行肘关节功能评价，优14例，良3例，可3例，优良率85％。术后伤13仅遗留轻微瘢痕，有神经、血管损伤患儿术后均基本恢复正常。结论小切口克氏针内固定术治疗儿童肱骨髁间骨折创伤小，手术时间短，恢复快，可有效减少手术并发症的发生，特别是对于Riseborough-RadinⅡ型、Ⅲ型骨折疗效佳。

英文摘要：

Objective To investigate the operative procedure and the therapeutic effects of minimally invasive incision and percutaneous pinning in operative treatment of humeral intercondylar fracture in children. Methods From January 2005 to September 2010,22 patients with humeral intercondylar fracture were treated with minimally invasive incision and percutaneous pinning. There were 16 males and 6 females, aged from 1 to 11 years （5.5 years on average）. There were 12 cases of Riseborough-Radin type-Ⅱ, type-Ⅲ in 8 cases, and type Ⅳin 2cases. Injury was caused by sports in 15 cases,by traffic accident in 3 cases,by falling from height in 3 cases, and by earthquake in 1 case. All fractures were closed, complicating other fracture in 10 cases, radial nerve injury in 5 cases,ulnar nerve injury in 1 cases, brachial artery injury in 1 cases, and forearm compartment syndrome in 3cases. The time from injury to hospitalization was 1 hour to 7 days. Neurovascular repair was performed at the same period. Results All incisions healed by first intention, no related complications occurred. 16 cases of postoperative X-ray films showed anatomical reduction ,6 patients with mild shift. A total of 20 patients were followed up 6. months to 3 years （ 12 months on average）. X-ray films showed fracture healed within 2-4 months （2.5 months on average）. Cubitus varus occurred in 3 cases, but the functions of elbow flexion and extension were good, continue to function exercise and follow-up observation. According to the Flynn et al criteria, the results were excellent in 14 cases, good in 3 cases, and fair in 3 cases;the excellent and good rate was 85%. Only a small incision scar was found, the function returned to normal in the cases complicated by nerve and blood vessel injury. Conclusion Minimally invasive incision and percutaneous pinning for operative treatment of humeral intercondylar fracture in children is a safe and effective surgical procedure, which has minimal trauma, short surgery time, quick recovery, simple operat