儿童移位肱骨髁上骨折的三级筛选式治疗  

Screening treatment of displaced supracondylar fracture of humerus in children

作　　者：肖林科 李国庆 白卫国 

机构地区：[1]扶风县胜利医院骨科

出　　处：《中国骨伤》2006年第1期3-5,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的：制定儿童移位肱骨髁上骨折的规范化治疗方案，避免和减少并发症的发生。方法：对136例骨折中轻度肿胀的89例采用手法复位，失败的38例连同重度肿胀的42例采用骨牵引复位，牵引复位失败中的23例（10例拒绝手术治疗）连同陈旧性骨折的5例采用手术切开复位的三级筛选式治疗，并对其疗效进行分析评价。结果：手法复位成功51例，骨牵引后复位成功47例，手术切开复位成功28例。10例手法复位失败后拒绝手术治疗，后期发生肘内翻。随访136例，时间3～48个月，骨折均在3个月内愈合，肘内翻畸形26例，占19％。无筋膜间室综合征、伤口及针孔感染的发生。结论：三级筛选式治疗方案可明显提高肱骨髁上骨折的闭合复位成功率，降低手术率，避免和减少了并发症的发生，是一种理想的治疗手段。Objective： To enact normative scheme for the treatment of displaced supracondylar fracture of humerus in children so as to avoid and lessen the complication. Methods：Among the 136 patients with displaced supracondylar fracture of humerus, light swollen 89 cases were treated by manipulative reduction, failed cases （38 cases） of manipulative reduction and heavy swollen 42 cases were treated by traction reduction, failed cases （23 cases） of traction reduction and old fracture（5 cases） were treated by operative reduction. The clinical results of all the patients were analyzed and evaluated. Results： 51 cases got success with manipulative reduction and 47 cases got success with traction reduction. 28 cases got success with operative reduction. Failed 10 cases of manipulative reduction gave up surgical treatment and occurred cubitus varus later period. 136 cases were followed up from 3 to 48 months, the fractures got healing in 3 months and cubitus varus deformity had 26 cases. Compartment syndrome, infection of wound and pinhole had not been found in all the patients. Conclusion：The screening scheme is an ideal therapeutic tool for displaced supracondylar fracture of humerus in children. It can improve the rate of closed reduction, decrease the rate of operation, avoid and lessen incidence of complication.

关 键 词：肱骨髁上骨折 正骨手法 牵引术 外科手术 

分 类 号：R683.41[医药卫生—骨科学] R197.32[医药卫生—外科学]