摘要
目的探讨中国北方青少年由于参加体育运动导致的肱骨髁上骨折的影像学诊断和近期治疗效果。方法回顾性分析2015年1月1日至12月31日在中国医科大学附属盛京医院小儿骨科住院治疗的儿童髁上骨折166例，其中由于体育运动导致者共56例。分析56例患儿的性别、致伤因素、受伤时年龄、伤后距离手术治疗的时间、肘关节正侧位X线片和肘关节三维CT表现、骨折合并神经损伤情况、手术方式以及临床随访结果。最后一次随访时的肘关节功能评价采用Flynn评分标准和Mayo肘关节功能评分系统（MEPS）。结果男34例[34肘，60.7% （34/56）]，女22例[22肘，39.3% （22/56）]；左侧32例[57.1% （32/56）]，右侧24例[42.9% （24/56）]。致伤因素均为肘关节伸展位或者屈曲位摔伤，其中踢足球16例[28.6% （16/56）]，打篮球10例[17.9% （10/56）]，滑冰10例[17.9% （10/56）]，滑雪8例[14.3% （8/56）]，轮滑5例[8.8% （5/56）]，滑板3例[5.3% （3/56）]，骑马2例[3.6% （2/56）]，单杠2例[3.6% （2/56）]。受伤时平均年龄9.5岁（6-13岁）；伤后距离手术平均2.2 d（4 h-35 d）；所有56例（56肘）均行伤侧肘关节正侧位X线片检查，分为伸直型54例[96.4% （54/56）]和屈曲型2例[3.6% （2/56）]。根据Gartland分型，伸直型54例中包括Gartland Ⅱ型20例[35.7% （20/56）]，Gartland Ⅲ型34例[60.7% （34/56）]，屈曲型2例均为Gartland Ⅱ型[3.6% （2/56）]。伸直型后内侧移位33例[58.9% （33/56）]，后外侧移位21例[37.5% （21/56）]，屈曲型前外侧移位2例[3.6% （2/56）]。23例（23肘）行肘关节三维CT重建，断端多显示粉碎骨折；骨折近端呈＂一＂形21例[91.3% （21/23）]，呈倒＂V＂形2例[8.7% （2/23）]。在5例肘关节正侧位X线片显示为Gartland Ⅱ型者CT显示为Ⅲ型骨折。合并桡神经损伤2例[3.6% （2/56）]；全部病例均行全麻下闭合复位术，46例[82.1% （46/56）]�
ObjectiveTo investigate the radiographic and clinical assessment for supracondylar humeral fractures resulted from sports in children.MethodsThe medical records of 166 patients with displaced supracondylar humerus fractures treated in Shengjing Hospital of China Medical University from January 2015 to December 2015 were reviewed.The etiology of 56 of 166 cases was relevant to the sports.Medical records of 56 of 166 patients were reviewed, incluidng gender, the mean age of patient at the time of surgery, the mean duration of injury, radiographic assessment based on the anteroposterior （AP） and lateral radiographs of the elbow, neurologic injury, the Mayo Elbow Performance Score （MEPS） and the criteria of Flynn.ResultsThere were 34 boys （34 elbows, 60.7% （34/56）） and 22 girls （22 elbows, 39.3% （22/56））, and 32 patients in left elbow （57.1% （32/56）） and 24 patients in right elbow（42.9% （24/56））. The etiology included football in 16 patients （28.6% （16/56））, basketball in 10 patients （17.9% （10/56））, skating in 10 patients （17.9% （10/56））, skiing in 8 patients （14.3% （8/56））, roller skating in 5 patients （8.8% （5/56））, kick scooter in 3 patients （5.3% （3/56））, riding horse in 2 patients （3.6% （2/56）） and horizontal bar in 2 patients （3.6% （2/56））. The mean age of 56 patients at the time of surgery was 9.5 years （ range from 6 to 13 years）. The mean duration of injury was 2.2 days （range from 4 hours to 35 days）. The AP and lateral radiographs of the elbow of all 56 patients （56 elbows） were performed, and three dimensional computed tomography（CT） were performed in 23 patients （23 elbows）. There were 54 patients in extension type（96.4% （54/56）） and 2 cases in flexion type （3.6% （2/56）） of supracondylar humeral fractures. There were 20 patients （35.7% （20/56）） of Gartland type Ⅱ and 34 patients （60.7% （34/56）） of Gartland type Ⅲ in 54 patients of extension-type.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第3期208-211,共4页
National Medical Journal of China
