摘要
目的探讨伸肘位手法复位ū形石膏槽板固定治疗儿童肱骨髁上骨折的临床疗效。方法对1997年8 月至 2012 年 2 月采用伸肘位手法复位ū形石膏槽板固定治疗并获得随访的 330 例肱骨髁上骨折患儿的病例资料进行回顾性分析。结果 330例患儿中骨折端达到解剖和/或功能复位322例,占97.6%;余8例手法复位不满意,改行交叉克氏针内固定结合ū形石膏槽板外固定。随访时间0.5～6年(平均3.4年)。骨折愈合时间3～6周(平均4.5周)。术后1、2、3个月及末次随访时的改良肘关节美国特种外科医院(HSS)评分均较术前有明显改善(P <0.05)。随访期间全组患儿肘关节屈伸功能均恢复正常。末次随访时X线片测量肘关节携物角为0°～5°者18例、6°～10°者246例、10°～15°者66例,平均肘关节携物角为11°。无迟发性肘内翻、外翻、过伸及内外旋转畸形,无Volkman缺血性肌挛缩。结论对于儿童肱骨髁上骨折,伸肘位有利于解剖/功能复位与固定;ū形石膏槽板设计合理、结构坚固、无需更换,能够维持骨折端稳定的固定效果,防止肘内翻畸形的发生。
Objective To analyze the clinical effect of manipulative reduction and ū-shape plaster channel-slab（ū-PCS） immobilization with elbow in extension for the treatment of pediatric supracondylar fractures of the humerus.Methods From August 1997 to February 2012,330 cases of pediatric supracondylar fracture of humerus were treated by manipulative reduction and ū-PCS stabilization with elbow in extension and received follow-up.Their clinical data were collected and analyzed retrospectively.Results Of these cases,322cases（97.6%） achieved anatomic and/or functional reduction,8 of them had unsatisfatory reduction and received Kirschner wire internal fixation combined with ū-PCS fixation.All of them were followed up from 0.5-6 years with the average of 3.4 years.Fracture heal time was 3-6 weeks with the average of 4.5 weeks.Compared with the preoperative modified scores of Hospital for Special Surgery（HSS） of elbow joint,those at 1,2,3 month after the operation as well as the last follow-up improved,and the difference had the statistical significance（P 0.05）.Extension and flexion functions of elbow joint recovered to normal in all patients.According to X-ray,carrying angle of elbow joint at the last follow-up ranged 0°-5°in 18 cases,6°-10° in 246 cases,and 10°-15° in 66 cases,with the average of 11°.No delayed cubitus varus,cubitus valgus,hyperextension,exterior/interior rotation deformity of elbow or Volkman ischemic contracture occurred.Conclusion For pediatric supracondylar fracture of humerus,the extension position of elbow is helpful for the anatomic/functional reduction and immobilization,and with the advantage of well design,firm structure and replaceless,ū-PCS has the effect of maintaining fracture stabilization which can avoid cubitus varus.
出处
《中国骨科临床与基础研究杂志》
2012年第5期345-349,共5页
Chinese Orthopaedic Journal of Clinical and Basic Research
基金
深圳市科技进步奖获奖项目(012044)
关键词
肱骨骨折
手法
骨科
伸肘位
石膏
外科
儿童
Humeral fractures
Manipulation
orthopedic
Elbow in extension
Casts
surgical
Child
