儿童肱骨髁上骨折闭合复位失败原因分析  

The analysis about the supracondylar fracture of humerus closed reduction failure in children

作　　者：张亚鹏[1] 谢婷婷[1] 姚杰[1] 孙军[1] 

机构地区：[1]安徽省立儿童医院骨科,合肥230051

出　　处：《安徽卫生职业技术学院学报》2013年第4期22-23,35,共3页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:分析儿童肱骨髁上骨折闭合复位失败的原因。方法:选择收治的肱骨髁上骨折172例患儿,22例闭合复位失败。先基础全麻或臂丛神经阻滞行C型臂透视下手法闭合复位,C型臂X线机透视下观察复位不成功后行切开复位或尺骨鹰嘴牵引治疗。结果:其中19例切开复位克氏针内固定石膏术,术中发现骨折断端肌肉神经卡压共9例,骨折两端骑跨旋转不能纠正的7例,骨折冠状面成斜形的有6例,3例行尺骨鹰嘴牵引治疗3周后石膏固定。结论:肱骨髁上骨折难以闭合复位的原因有:肿胀严重、屈曲桡偏型、骨折面成斜形、骨折两端骑跨旋转,骨折断端嵌入肌肉神经的软组织,故临床工作时遇到这些情况时慎用闭合复位,避免反复复位造成肘部软组织严重挫伤而带来严重的后果。Objective：To analyze the supracondylar fracture of h^merus closed reduction failure in children. Meth- ods： our orthopedic ward treated 172 cases with supracondylar fracture of humerus. There were 22 cases of closed re- duction failure.With basic anesthesia or brachial plexus nerve block line, the fracture do closed reduction under C-arm. If closed reduction failure, the fracture do open reduction or ulna olecranon traction therapy.Results：19 of the 22 patients do the open reduction with kirschner wire internal fixation and plaster external fixation, 3 of the 22 pa- tients do ulna olecranon traction for 3 weeks and after 3 weeks do the plaster external fixation.Conclusion：Di^cuh closed reduction results from severe swelling, buckling radial partial, coronal plane of fracture with oblique shape, fractures at both ends straddles and rotation, and fracture fiilled by muscle and nerve, so the clinical work should be careful when meeting these situations to avoid the repeated elbow soft tissue swelling can bring serious consequence. reset causing elbow soft tissue swelling serious because the

关 键 词：儿童 肱骨髁上骨折 闭合复位 

分 类 号：R683.41[医药卫生—骨科学]