儿童肱骨髁上骨折的分级治疗  

Screening Treatment of Superacondylar Fractures of the Humerus in Children

作　　者：宋财[1] 郭学德[1] 马成才[1] 

机构地区：[1]安徽省亳州市人民医院骨科,236800

出　　处：《中华全科医学》2011年第9期1386-1387,共2页Chinese Journal of General Practice

摘　　要：目的观察分级治疗模式对儿童肱骨髁上骨折的疗效。方法对56例儿童肱骨髁上骨折治疗方案分为三级。其中GartlandⅠ型6例,GartlandⅡ型19例,GartlandⅢ型31例,其中屈曲型2例,伴有神经损伤2例,患肢肿胀特别严重者2例。对GartlandⅠ型骨折,单纯应用石膏外固定;GartlandⅡ型和GartlandⅢ型骨折,首选闭合复位、经皮穿针内固定;闭合复位、经皮穿针失败者或伴有明显血管、神经损伤症状者以及患肢肿胀特别严重者,给予切开复位克氏针内固定。结果 56例随访18～29个月,平均20.6个月,按Flynn功能评价标准,优42例,良13例,差1例。结论对儿童肱骨髁上骨折采取分级治疗模式能够取得很好疗效,有效减少并发症的发生。Objective To observe the clinical outcomes of screening treatment to superacondylar fractures of the humerus in chihtren. Methods The treatments of superaeondylar fractures of the humerus in children were divided into three grades. 6 cases in which Gartland I , Gartland II type 19 cases, Gartland Ill type 31 cases ,2 cases in which flexion, accompanied by nerve injury in 2 cases, especially serious limb swelling in 2 patients. To Gartland type I fracture, fixate with plaster only. To Gartland type II and In fractures, it was in preference to others that close reduce and percutaneous pins fixation. Open reduction and internal fixation were employed to that failed cases after close reduction and percutaneous pins fixation, or company with vascular or nerves injury, or limb severe swelling. Results Fifty-six cases were evaluated by the Flynn score system for the elbow joint, among them, excellent in forty-two, good in thirteen, and bad in one. Conclusion Screening treatment had excellent clinical outcomes to superacondylar fractures of the humerus in children. It can decrease the rate of complication.

关 键 词：肱骨髁上骨折 分级治疗 内固定 外固定 儿童 

分 类 号：R683.413[医药卫生—骨科学]