两种不同手术入路治疗小儿肱骨髁上骨折的比较  

Comparison of two approaches for the treatment of supracondylar fractures of the children

作　　者：沈爱东[1] 杨惠光[1] 张云庆[1] 周枫[1] 邓雄伟[1] 丁伟[1] 

机构地区：[1]东南大学医学院附属江阴医院骨科,江苏江阴214400

出　　处：《临床骨科杂志》2009年第4期428-430,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较舌形瓣切断肱三头肌与经肱三头肌两侧两种手术入路治疗小儿肱骨髁上骨折的临床疗效。方法对45例小儿肱骨髁上骨折患儿采用舌形瓣切断肱三头肌手术入路+交叉克氏针固定复位+石膏托外固定24例,经肱三头肌两侧手术入路+交叉克氏针固定复位+石膏托外固定21例。观察对比两种术式的治疗效果。结果45例均获随访,时间3～12个月,肱三头肌两侧组的手术时间、术中失血量、术后石膏外固定的时间以及术后3d内疼痛均少于舌形瓣切开组(P<0.05)。参照Flynn标准:肱三头肌两侧组有16例肘关节屈伸不受限,而舌形瓣切开组中仅11例达到此标准,差异有统计学意义(P<0.05)。结论经肱三头肌两侧入路治疗小儿肱骨髁上骨折具有操作简便快捷、手术时间短、失血量较少、患者疼痛减轻、疗效满意等优点。Objective To compare the method and outcome for supracondylar fractures of the children through bilateral tricep brachii and splitting it open in linguiform.Methods 24 cases of supracondylar fractures were treated by splitting tricep brachii open in linguiform and 21 cases through bilateral tricep brachii.All cases were undergone internal fixation with Kirschner wire and plaster immobilization. Curative effect was observed.Results All cases were followed up for 312 months.All fractures got union.Curative effect of the cases who were treated through bilateral tricep brachii was better than the other （operation duration,blood loss,duration of plaster mmobilization and pain）.According to Flynn standard,the range of motion of articulatio cubiti was normally restored in 16 cases who were treated through bilateral tricep brachii,and 11 cases in the other group.The results were significant different （P〈0.05）.Conclusions It is minimally invasive and simple in the treatment of supracondylar fractures of the child ren with bilateral triceps approaches,which permits many advantages,such as stable fixation,early exercises and satisfactory elbow function recovery.

关 键 词：肱骨髁上骨折 手术入路 骨折固定术 内 石膏 外科 儿童 病例对照研究 

分 类 号：R683.41[医药卫生—骨科学] R687.3[医药卫生—外科学]