儿童漂浮肘损伤的治疗  

Treatment of "floating elbow"in children

作　　者：向慧[1] 张德文[1] 覃佳强[1] 刘星[1] 李明[1] 

机构地区：[1]重庆医科大学附属儿童医院骨科,重庆400014

出　　处：《创伤外科杂志》2009年第6期512-514,共3页Journal of Traumatic Surgery

摘　　要：目的分析儿童漂浮肘的受伤机制及病理解剖类型,探讨其治疗方法。方法对2006-2008年的20例儿童漂浮肘进行回顾性研究。肱骨干骨折5例,肱骨髁上骨折9例,肱骨髁部骨折6例（分别为Salter-HarrisⅡ型1例,Ⅲ型3例,Ⅳ型2例）。尺桡骨双骨折9例,单纯桡骨远端骨折6例。对移位明显的骨折采用手术治疗,移位不明显的采用手法复位。术中术后密切观察肢体、肢端血运。结果按修订F lynn表中对疗效作客观的评价。17例患儿前臂旋转和肘关节的功能正常;2例有13°肘关节欠屈,10°前臂旋转受限;1例有18°肘关节欠屈,15°前臂旋转受限。无肘内外翻畸形,无感染。结论对于漂浮肘应根据情况采用相应的治疗措施,治疗结果是满意的。Objective To analyze the mechanism, pathological anatomy of injury and investigate the treatment methods of ＂ floating elbow＂ in children. Methods From 2006 to 2008, the data of 20 cases of ＂floating elbow＂ with average age of 6.7 years were retrospectively reviewed. Humeral shaft fractures occurred in 5 cases,supraeondylar fracture of the humerus in 9 cases. One patient with humeral fractures belonged to Salter-Harris Ⅱ 13 cases type Ⅲ and 2 cases type Ⅳ. Both the radius and ulna were fractured in 9 cases,simple radius fractures in 6 cases and simple ulna fractures in 4 cases. The obviously-displaced fractures were treated by surgery, and nonobliously displaced fractures by manual reduction. The blood circulation was closely monitored intra- and post-operatively. Results According to the modified Flynn criteria,two had 13°limitation of the range of elbow motion and 10°limitation of forearm supination. The worst case had 18°limitation of elbow flexion and 15°limitation of forearm supination. The remaining 17 cases had satisfactory elbow and foream movements. No residual varus and infection were found in all cases. Conclusion Treatment of floating elbow ought to be treated based on the patients＇ condition ,and the treatment outcome is satisfying.

关 键 词：儿童 漂浮肘 治疗 

分 类 号：R683.41[医药卫生—骨科学]