肱骨髁上骨折伴桡神经损伤41例的手术治疗  

Surgical Treatment of Humeral Supracondylar Fracture with Radial Nerve Injury in 41 Children

作　　者：沈阳[1,2] 陈柏松[1,2] 沈云东[3] 

机构地区：[1]上海市儿童医院 [2]上海交通大学附属儿童医院骨科,上海200040 [3]复旦大学附属华山医院手外科,上海200040

出　　处：《实用儿科临床杂志》2012年第11期839-840,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨儿童肱骨髁上骨折伴桡神经损伤的手术治疗效果。方法通过回顾性分析上海市儿童医院收治的儿童肱骨髁上骨折伴桡神经损伤的患儿41例的临床资料,将其分为2组。研究组为肱骨髁上骨折切开复位并行Ⅰ期神经探查修复;对照组为肱骨髁上骨折外院处理骨折愈合后伴神经损伤,术后2～4个月至本院进行Ⅱ期神经探查修复。对2组患儿在神经修复治疗后功能恢复情况进行分析。结果研究组18例中疗效优13例、良4例、一般1例,优良率为94.44%;对照组23例中疗效优6例、良12例、一般3例、差2例,优良率仅为78.26%。Ⅰ期手术患儿桡神经功能恢复优良率要优于Ⅱ期手术患儿(P=0.028)。结论儿童肱骨髁上骨折伴桡神经损伤,Ⅰ期处理骨折的同时积极处理损伤的桡神经,能取得满意疗效。Abstract： Objective To investigate the effect of surgical treatment of humeral supracondylar fracture with radial nerve injury in chil- dren. Methods Clinical data of 41 children of humeral supracondylar fracture with radial nerve injury in Shanghai Children＇s Hospital were retrospectively analyzed,and the patients were divided into 2 groups. The cases in study group had open reduction of humeral supracondylar fractures with stage I nerve exploring and repairing,while the cases in control group had stage Ⅱ nerve exploring and repairing,which were 2 - 4 months after reduction of the fracture in other institutions. The data of nerve function recovery were analyzed retrospectively. Results Study group consisted of 18 cases. The results represented as excellent, efficacy in 13 cases, good efficacy in 4 cases, common efficacy in 1 case, and the rate of excellent and good was 94.44% ;while control group consisted of 23 cases, the results represented as excellent efficacy in 7 cases, good efficacy in 11 cases, common efficacy in 3 cases and bad efficacy in 2 cases, the rate of excellent and good was 78. 260/0. The ra- dial nerve function recovery in study group was better than that in control group（ P = 0. 028）. Conclusion Open reduction of humeral supra- condylar fractures with radial nerve injury in children by using stage I nerve exploring and repairing can achieve more satisfactory results than stage Ⅱ nerve exploring and repairing.

关 键 词：肱骨髁上骨折 桡神经损伤 手术治疗 儿童 

分 类 号：R726.8[医药卫生—儿科]