儿童严重移位肱骨髁上骨折伴神经损伤的治疗策略  

The therapeutic strategy of humeral supracondylar fracture with never injury in children

作　　者：仲肇平[1] 曹进[1] 任荣[1] 彭琳瑞[1] 陈秋[1] 

机构地区：[1]宁波市第六医院小儿骨科,浙江宁波315040

出　　处：《中国骨伤》2009年第1期27-28,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨儿童肱骨髁上骨折伴神经损伤的临床特点及治疗策略。方法:对2000年6月至2006年12月收治的28例肱骨髁上骨折伴神经损伤的患儿进行总结分析,所有骨折均为GartlandⅢ型,其中闭合性损伤24例,开放性损伤4例。16例(A组)行闭合复位穿针固定,12例(B组)行骨折切开复位并神经探查。切开手术者发现8例神经为挫伤,3例为嵌顿伤,1例为断裂伤。结果:28例神经功能均完全恢复,其中闭合复位穿针者4～6周内恢复13例,8～10周2例,12周1例;切开手术者神经功能恢复4～6周6例,8～10周3例,12～16周3例。结论:儿童肱骨髁上骨折伴神经损伤者,大部分损伤的神经功能可以在骨折闭合复位后逐步恢复,但必要时切开复位、神经探查、修复,同样有重要的现实意义。Objective ：To determine the clinical features and therapeutic strategy of humeral supracondylar fractures with nerve injuries in children. Methods： From June 2000 to December 2006,28 patients of humeral supracondylar fracture （Gartlang Ⅲ ）with never injuries were analyzed. Twenty-four patients were close injuries and the others were open. Sixteen cases （group A）were treated with close reduction and K-wires fixation. Twelve cases （group B）were treated with open reduction and nerve exploration, among them, contusive nerve injuries in 8 cases, incarceration in 3, complete neurotmesis in 1. Results：The symptoms of nerve injuries of 28 cases recovered completely within 4 to 6 weeks in 13 cases, 8 to 10 weeks in 2 cases and 12 weeks in 1 case in group A,meanwhile ,within 4 to 6 weeks in 6 cases,8 to 10 weeks in 3 cases and 12 to 16 weeks in 3 cases in group B. Conclusion： Most nerve injuries in humeral supracondylar fractures in children can be cured after close reduction of the fracture. Sometimes, open reduction and nerve exploration are necessary, which has important practical significance.

关 键 词：肱骨髁上骨折 神经损伤 儿童 临床方案 

分 类 号：R683.41[医药卫生—骨科学] R651.3[医药卫生—外科学]