儿童肱骨远端骨骺分离的手术治疗  

The Operative Treatment in Children＇s Distal Humeral Epiphyseal Separation

作　　者：姜海[1] 汪兵[1] 吴永涛[1] 苗武胜[1] 吴革[1] 

机构地区：[1]西安市红十字会医院儿骨科,710054

出　　处：《美中国际创伤杂志》2011年第2期23-24,11,共3页U.S.Chinese International Journal of Traumatology

摘　　要：目的：探讨手术治疗儿童肱骨远端骨骺分离的疗效。方法：自2002年1月至2006年8月，收治12例肱骨远端骨骺分离的患儿，按Salter—Harris分型：I型7例，Ⅱ型5例。合并桡神经损伤1例。9例采用肘关节外侧入路，3例采用肘关节后侧入路，行切开复位克氏针内固定治疗。术后拍片复查，3N6周拔除克氏针行功能锻炼。结果：本组12例，随访1-6年，平均36个月，骨折愈合时间3-6周，平均4周；9例患肘屈伸活动良好，2例患肘屈曲受限，1例发生肘内翻。1例桡神经损伤神经功能完全恢复。结论：儿童肱骨远端骺分离复位困难，行手术切开复位内固定治疗，可以解剖复位，减少肘内翻的发生。外侧入路对肘关节功能影响小，术后功能恢复良好。Objective： To investigate the curative effect of operative treatment for children＇s distal humeral osteoepiphysis fracture. Methods： From January 2002 to August 2006, 12 cases were treated by operation. According to Salter-Harris system, there were 7 patents with type I fracture, 5 patents with type 11 fracture. There was 1 case combined with radial nerve injury. 9 cases were operated by lateral approach and 3 cases by posterior approach. All cases were fixed with Kirschner wire after open reduction, postoperative radiographs were carried out immediately to determine reduction accuracy, Kirschner wires were removed after 6 weeks and exercises was given at once. Results： All patients were followed up for 1 year to 6 years, the healing time of fracture was 3-6 weeks, flection and extention activity of elbow joint was good in 9 cases and limited in flection in 2 cases, cubitus varus was noted in 1 case, and 1 case of radial nerve injury was totally recovered. Conclusion： It is difficult to obtain an anatomical contraposition by close reduction. Open reduction can get an anatomical contraposition and decrease the deformity, and lateral approach is recommended.

关 键 词：儿童 肱骨远端骨折 手术 

分 类 号：R683.41[医药卫生—骨科学]