三维旋转手法复位治疗Gartland Ⅲ型儿童肱骨髁上尺偏型骨折的临床疗效观察  

Clinical Curative Observation of Three-dimensional Rotational Manual Reduction on Treating Gartland Ⅲ Humeral Supracondylar Fractures of Extension Ulnar Type in Children

作　　者：乐劲涛 李小红[2] 沈海[1] 王英[1] 周英[1] 

机构地区：[1]四川省骨科医院,四川成都610041 [2]成都体育学院附属体育医院,四川成都610041

出　　处：《四川中医》2013年第9期96-99,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省中医药管理局科技专项课题(编号:2010-60)

摘　　要：目的：探索三维旋转手法复位治疗Gartland III型肱骨髁上尺偏型骨折的临床疗效和意义。方法：以4~12岁Gartland III型肱骨髁上尺偏型骨折的儿童患者为研究对象,设立三维旋转手法复位配合尺骨鹰嘴牵引治疗为试验组,设立传统手法复位配合尺骨鹰嘴牵引治疗为对照组;采用同期单盲随机平行对照的方法,采用两组肿胀程度及复位次数的分析、总体疗效、骨折愈合时间、肘关节功能恢复时间、肘内翻畸形发生率和发生程度等指标观察和比较两组的临床疗效。结果：两组均达骨性愈合,神经损伤均在4个月内恢复。两组肿胀程度及复位次数的分析、总体疗效、肘内翻发生率和肘内翻程度、肘关节功能恢复时间比较,差异有统计学意义（P〈0.05）,试验组优于对照组;两组骨折愈合时间比较,差异无统计学意义（P〉0.05）。结论：三维旋转手法具有骨折复位准确性提高,肘关节周围软组织损伤减轻,肘内翻畸形发生率降低,临床疗效提高的优势,值得临床推广。Objective： To explore the clinical effects and significance of manual reduction for GartlandⅢ humeral supracondylar fractures of extension ulnar type with three-dimensional rotational manipulation. Methods： Children between 4 and 12 with GartlandⅢ humeral supracondylar fractures of extension ulnar type were targeted at and were divided into trial group and comparison group. The trial group took three- dimensional rotational manipulation for manual reduction combine with skeletal traction through olecranon of ulna and the comparison group traditional manual reduction combine with skeletal traction through olecranon of ulna. By means of synchronous randomized parallel controlled study with single-blinded method,observing and comparing the clinical effects of the two groups through the general curative effect,fractures healing time,elbow functional recovery time and the incidence rate and degree of cubitus varus deformity. Results： Bone union could be seen and nerve injuries could be return to normal in 4 months in both of the two groups. The trial group was better than the comparison group through the comparison of the general curative effect,incidence rate and degree of cubitus varus and elbow functional recovery time were statistically significant. The differences were too small to be statistically significant through the comparison of fractures healing time. Conclusion： Three-dimensional rotational manipulation has the advantage of increasing the accuracy of fracture reduction as anatomical reduction,relieving the damage of soft tissue around the elbow joint,lowering the rate of anchylosis and cubitus varus deformity and improving the clinical effects. It is worth popularizing in the clinic.

关 键 词：肱骨髁上骨折 三维旋转手法 医师诊疗模式 

分 类 号：R681.7[医药卫生—骨科学]