不同入路治疗儿童Gartland Ⅲ型肱骨髁上骨折  

Treatment for type Ⅲ supracondylar fractures of the humerus in children by different approaches

作　　者：王远辉[1] 叶里子[1] 田泽高[1] 谭美云[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000

出　　处：《现代预防医学》2012年第11期2707-2708,共2页Modern Preventive Medicine

摘　　要：目的观察不同入路治疗儿童Gartland Ⅲ型肱骨髁上骨折的临床疗效。方法 2005年1月-2010年10月间,选择某科50例肱骨髁上骨折(Gartland Ⅲ)患儿。随机分为两组:肘后侧入路组(n=25);肘内侧入路组(n=25)。患儿均全麻后,按分组行切开复位克氏针手术治疗。术后石膏外固定4周。照Flyrm临床功能评定标准对肘关节功能进行评价。结果所有病例均得到随访,随访时间12～24个月。平均19个月。骨折均愈合良好。6例神经损伤者在8-10周恢复。随访期内两组各有1例出现肘内翻畸形。肘内侧入路的肘关节优良率为88%,肘后侧入路的肘关节优良率为64%,两者比较差异有统计学意义(P﹤0.05)。结论肘关节内侧入路治疗Gartland Ⅲ型肱骨髁上骨折较后侧入路简便、容易,肘关节功能恢复良好。OBJECTIVE To observe the efficacy of treatment for type Ⅲ supracondylar fractures of the humerus in children by different approaches.METHODS 50 children who had humeral supraeondylar fracture（Gartland Ⅲ）treated in our department from January 2005 to October 2010 were analyzed.50 cases were divided into 2 groups and treated with inside and posterior approaches.When the patients were under general anesthesia,open reduction was performed and the fracture was fixed with Kirsehner wires.The elbow and wrist joints were fixed in the functional position with plaster for 4 weeks.Outcomes were measured according to Flynn criteria.RESULTS All patients were followed up for average 19 months（12-24 months）.All cases obtained bone union.6 nerval injury cases were recovered.There was 1 case of cubitus varus deformity in every group.The excellent-good rate of elbow functions in group one and two was 64% and 88%,respectively.There was a significant difference between the two group（P﹤0.05）.CONCLUSION Inside approach is simple,easy and can improve the elbow joint function compared to posterior approach.

关 键 词：儿童 肱骨髁上骨折 手术入路 

分 类 号：R683.41[医药卫生—骨科学]