摘要
目的探讨布巾钳尺骨鹰嘴牵引联合不同经皮克氏针穿针固定方式治疗儿童难复性肱骨髁上骨折的临床疗效。方法回顾性分析91例难复性肱骨髁上骨折患儿的临床资料,将行布巾钳尺骨鹰嘴牵引联合经皮外侧克氏针穿针固定治疗的42例患儿作为A组,将行布巾钳尺骨鹰嘴牵引联合经皮外侧内侧交叉克氏针穿针固定治疗的49例患儿作为B组。比较两组患儿治疗前、治疗后3个月、治疗后6个月及末次随访时患肢Baumann角、提携角及Mayo肘关节功能评分。评估两组患儿治疗后3个月、治疗后6个月及末次随访时肘关节功能恢复情况。比较两组患儿骨折愈合时间、住院时间及术后并发症发生情况。结果治疗后3个月、治疗后6个月、末次随访时两组患儿的Baumann角较治疗前减小,提携角、Mayo肘关节功能评分较治疗前增加(P<0.05),但两组间各时间点Baumann角、提携角、Mayo肘关节功能评分差异无统计学意义(P>0.05)。治疗后3个月、治疗后6个月及末次随访时两组患儿肘关节功能恢复优良率差异无统计学意义(P>0.05)。两组患儿的骨折愈合时间、住院时间、术后骨折再移位的发生率差异无统计学意义(P>0.05);B组患儿术后尺神经损伤发生率高于A组(P<0.05)。结论布巾钳尺骨鹰嘴牵引联合经皮外侧克氏针穿针固定或联合经皮外侧内侧交叉克氏针穿针固定治疗儿童难复性肱骨髁上骨折,均可改善患肢Baumann角与提携角,促进肘关节功能恢复,且临床疗效相当,但前者并发尺神经损伤的发生率更低,安全性更好。
Objective To investigate the clinical eficacy of towel clamp ulna olecranon skeletal traction combined with different percutaneous Kirschner wire needle fixation methods for the treatment of children with irreducible supracondylar fracture of humerus.Methods The clinical data of 91 children with irreducible supracondylar fracture of humerus were retrospectively analyzed,and 42 children treated with towel clamp ulna olecranon skeletal traction combined with percutaneous lateral Kirschner wire needle fixation belonged to group A,while 49 children treated with towel clamp ulna olecranon skeletal traction combined with percutaneous lateral-medial cross Kirschner wire needle fixation belonged to group B.The Baumann angle,carrying angle,and the Mayo elbow joint function score of the affected limb before treatment,3 and 6 months after treatment,and at the last follow-up were compared between children of the two groups.The recovery of elbow joint at 3 and 6 months after treatment,and at the last follow-up were evaluated in children of both groups.The fracture healing time,length of hospital stay,and occurrence of complications were compared between children of the two groups.Results After 3 and 6 months of treatment,and at the last follow-up,the Baumann angle in the two groups was smaller as compared with before treatment,and the carrying angle,Mayo elbow joint function score were increased as compared with before treatment(P<0.05),but no statistically significant difference in the Baumann angle,carrying angle,and Mayo elbow joint function score at various time points was found between the two groups(P>0.05).After 3 and 6 months of treatment,and at the last follow-up,the excellent and good rate of elbow joint function recovery in children of the two groups exhibited no statistically significant difference(P>0.05).There was no statistically significant difference in fracture healing time,length of hospital stay,incidence rate of postoperative fracture redisplacement between the two groups(P>0.05).The incidence rate of pos
作者
杨烨
刘彬
YANG Ye;LIU Bin(Department of Pediatric Surgery,Baoji Maternal and Child Health Care Service Center,Baoji 721000,Shaanxi,China;Department of Pediatric Orthopedics,the First People′s Hospital of Xianyang,Xianyang 712000,Shaanxi,China)
出处
《广西医学》
CAS
2023年第16期1928-1933,共6页
Guangxi Medical Journal
关键词
难复性肱骨髁上骨折
布巾钳牵引
穿针固定
克氏针
儿童
临床疗效
Irreducible supracondylar fracture of humerus
Towel clamp traction
Needle fixation
Kirschner wire
Children
Clinical efficacy
