动力型支具对稳定儿童肱骨髁上骨折中后期Baumann角的临床意义  

Dynamic external fixation for stabilizing Baumman angle during midanaphase in supracondylar fracture of humerus in children

作　　者：李伟强[1] 郭跃明[1] 何健[1] 卢凤珊[1] 

机构地区：[1]佛山市中医院骨科,广东佛山528000

出　　处：《中国骨伤》2013年第8期656-658,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:使用自行研制的动力型肘关节支具,通过观察其患健侧Baumann角(B角)角度差的变化,评估其用于预防儿童肱骨髁上骨折并发肘内翻的作用。方法:2010年10月至2012年4月X线片诊断为GartlandⅡ、Ⅲ型闭合性肱骨髁上骨折患者共120例,分为治疗组和与对照组。治疗组62例,男48例,女14例,年龄(7.27±4.36)岁,病程(1.48±1.26)d;对照组58例,其中男47例,女11例,年龄(8.02±3.82)岁,病程(1.20±1.11)d。治疗组和对照组均采用手法整复、小夹板外固定。治疗组复位15d后使用肘支具,直至90d观察结束。对照组使用小夹板外固定,30d后去除小夹板。两组于复位后即刻、15d、30d、60d、90d、6个月、1年拍X线片测量B角,复位后同时摄健侧X线片测量健侧B角,并计算患侧与健侧B角差。复位后90d及1年时参照Flynn标准进行肘关节功能评价。结果:所有病例有1年以上随访,均达到骨折治愈标准。随访肘内翻发生情况:治疗组无,对照组4例。患健侧B角差随时间的推移有逐渐增大的趋势,复位后30d开始至90d对照组B角差增加的幅度比治疗组大(P<0.01)。结论:应用动力型弹性外固定支具对稳定肱骨髁上骨折中后期B角有确定性效果。Objective：To evaluate the function of preventing supracondylar fracture of the humerus and cubitus varus in children by observing Baumann angle changes with self-made Orthopedic elastic elbow brace. Methods：From October 2010 to April 2012,120 patients with closed GartlandⅡor III supracondylar fracture of the humerus diagnoised by X ray were divided into two groups as follows：group A （62 cases,including 48 males and 14 females,with an average age of （7.27±4.36） years old,and the course of （1.48 ±1.26） days）;group B （58 cases,including 47 males and 11 females,with an average age of （8.02±3.82） years old,and the course of （1.20±1.11） days. The two groups were treated by manipulative reduction and external fixation of small splints. Group A were used with elbow brace at 15 days after reduction ,and treated for 90 days. Group B were used with external fixation of small splints and removed at 30 days. Baumann angle changes at different time periods （15 days,30 days,60 days,90 days,6 months,1 year） after reduction and its＇ opposite side were recorded by X ray. The angles of injured side and the opposite side were compared. The function of the elbow brace was evaluated at 90 days or 1 year after re- duction according to Flynn. Results：All cases were followed up for over 1 year and obtained fracture healing. The incidence of cubitus varus was no one in group A and 4 cases in group B. The Baumann angles of injured side were trended to be increased with the time passing. From 30 days after reduction to 90 days,the increased angles of group B is more than that of group A （P 0.01）. Conclusion：It is effective on stabilizing Baumman angle in the supracondylar fracture of the humerus of midanaphase treatment in Children by orthopedic elastic elbow brace.

关 键 词：肱骨骨折 肘 畸形 外固定器 儿童 

分 类 号：R683.41[医药卫生—骨科学]