摘要
目的 比较闭合复位、闭合复位内固定与有限切开复位内固定治疗儿童Delee B型肱骨远端经骺板骨折的疗效.方法 回顾性分析2008年1月至 2015年6月收治并获随访的36例儿童Delee B型肱骨远端经骺板骨折患儿资料,其中闭合复位组（闭合复位石膏固定）7例,男6例,女1例;平均年龄21个月.闭合复位内固定组（闭合复位克氏针内固定）11例,男8例,女3例;平均年龄23个月.有限切开复位内固定组（行小切口有限切开复位克氏针内固定）18例,男12例,女6例;平均年龄22.5个月.比较三组患儿术后1年肘关节功能及患侧与健侧提携角差别.结果 所有患儿获得12~60个月（平均26个月）随访.所有患儿均在术后4周获骨折临床愈合.术后1年时,按照Flynn肘关节评分标准评定疗效：闭合复位组优良率57.1%（4/7）,闭合复位内固定组81.8%（9/11）,有限切开复位内固定组100%（18/18）.三组患儿患侧肘关节提携角与健侧差别分别为（17.4±5.2）°、（5.6±1.8）°、（3.5±0.8）°.三组比较及组间两两比较差异均有统计学意义（P〈0.05）.闭合复位组3例和闭合复位内固定组1例均因肘内翻行髁上截骨术.三组均无骨折延迟愈合、骨筋膜室综合征及医源性血管神经损伤等并发症发生.结论 治疗儿童Delee B型肱骨远端经骺板骨折,行有限切开复位经皮克氏针内固定,与闭合复位、闭合复位内固定相比,可获得更好的疗效,患侧后遗肘内翻程度更低.
Objective To compare the clinical efficacies of closed reduction,closed reduction ＆amp; internal fixation,limited open reduction ＆amp; internal fixation for Delee type-B fracture-separation of distal humeral epiphysiolysis in children.Methods The clinical data of 36 children with Delee type-B fracture-eparation of distal humeral epiphysiolysis from January 2008 to June 2015 were retrospectively analyzed.The approaches were closed reduction （n=7）,closed reduction ＆amp; internal fixation （n=11） and open reduction via a limited medial or lateral incision ＆amp; internal fixation （n=18）.In closed reduction group,there were 6 boys and 1 girl with a mean age of 21 months;in closed reduction ＆amp; internal fixation group,8 boys and 3 girls with a mean age of 23 months;in limited open reduction group,12 boys and 6 girls with a mean age of 22.5 months.Three groups were compared with regards to Flynn elbow scoring and carrying angle difference between affected side and contralateral side at 1 year postoperation.Results During a mean follow-up period of 26 （12-60） months,all fractures achieved clinical healing at 4 weeks postoperation.By the Flynn elbow scoring at 1 year postoperation,the good-to-excellent rate was 57.1% （4/7） in closed reduction group,81.8% （9/11） in closed reduction ＆amp; internal fixation group and 100% （18/18） in limited open reduction group with significant differences （P〈0.05）.The carrying angle difference between affected and contralateral sides at 1 year postoperation were 17.40±5.20,5.60±1.80 and 3.50±0.80 with significant differences （P〈0.05）.Three cases in closed reduction group and 1 case in closed reduction ＆amp; internal fixation group required supracondylar osteotomy for elbow varus.No delayed union,compartment syndrome or iatrogenic vascular or nervous lesions occurred in all groups.Conclusions For Delee type-B fracture-separation of distal humeral epiphysiolysis in children,as compared with closed reduction and closed reduction ＆amp;
出处
《中华小儿外科杂志》
CSCD
2017年第4期301-306,共6页
Chinese Journal of Pediatric Surgery
关键词
骨折
复位
固定
Fracture
Reset
Fixation
