肱三头肌两侧入路手术治疗儿童GartlandIII型肱骨髁上骨折的疗效  

Clinical results of bilateral triceps bradhii approach in Gartland m supracondylar fracture of humerus in chidren

作　　者：王干威[1] 陈奕彬[1] 陈海波[1] 

机构地区：[1]汕头市中医医院骨二科广州中医药大学附属汕头医院,广东省汕头515031

出　　处：《中国基层医药》2010年第6期723-724,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的通过与手法闭合复位石膏固定比较，探讨肱三头肌两侧入路手术对于儿童GartlandⅢ型肱骨髁上骨折的治疗效果。方法选102例4～13岁GartlandIII型肱骨髁上骨折息儿作为研究对象，按照随机分组的原则分为手术组和对照组，每组各51例，其中手术组进行肱三头肌两侧入路手术，对照组则通过手法闭合复位后石膏固定。两组患者均于治疗后4周进行功能锻炼，并且定期进行x线检查，所有患者术后随访10-20个月（平均16个月），随访时检查和记录提携角改变、肘关节屈伸功能情况。按照Flynn临床功能评定标准对所有患者进行分类后，再进行统计学分析。结果随访后肘关节功能评价，手术组优35例，良13例，可3例，差0例，优良率为94．1％；对照组患者优16例，良16例，可15例，差4例，优良率为62．7％，且两组间差异有统计学意义（P〈0．05）。结论与手法闭合复位石膏固定相比，肱三头肌两侧人路手术对于儿童GartlandIII型肱骨髁上骨折治疗效果临床满意，优良率高，是临床上较为有效的治疗方法。Objective To investigate clinical results of bilateral triceps bradhii approach in Gart^and Ill su- pracondylar fracture of humerus in children by comparing with reduction interne and plaster immobilization. Methods 102 children with Gartland III supracondylar fracture of humerus ,4 - 13 years old ,from May 2003 to May 2009, were randomly divided into operation group and control group ,51 cases separately, The operation group was treated by bilateral triceps bradhii approach, while control group was treated by reduction interne and plaster immobilization. All patients were made function exercise 4 weeks later, X-ray check periodically and followed up about 16 months with angle patronner and elbow joint function recorded. According to Flynn clinical function criteria, all patients were classified and analyzed. Results After follow-up and elbow joint function evaluation, 48 cases （94. 1% ） show excellent and good results,3 cases（5.9% ） fair and poor in operation group,32 cases（62.7% ） and 19 cases（37.3% ） in con- trol group. The differences between two groups was statistically singnificant （ p 〈 0, 05）, Conclusion Comparing with reduction interne and plaster immobilization, bilateral triceps bradhii approach in Gartland III supracondylar fracture of humerus in children has good clinical results and may be more effective therapy.

关 键 词：手法闭合复位 骨折内固定术 外固定术 肱骨髁上骨折’ 

分 类 号：R726[医药卫生—儿科]