极度旋前复位桡骨头半脱位的基础与临床研究  

Hyperpronation in Reduction of Radial Head Subluxation

作　　者：张华亮[1] 曾剑文[1] 罗志平[1] 饶海群[1] 王文良[2] 

机构地区：[1]中国人民武装警察部队江西总队医院骨科,南昌330030 [2]中国人民武装警察部队后勤学院附属医院骨科,天津300163

出　　处：《南昌大学学报（医学版）》2013年第8期28-31,共4页Journal of Nanchang University：Medical Sciences

基　　金：中国人民武装警察部队江西总队医院课题(wj200312)

摘　　要：目的结合解剖学研究和临床对比极度旋前、旋后两种复位桡骨头半脱位的效果。方法解剖20例婴幼儿肘关节标本,测量桡骨头、颈矢状径和横径、环状韧带上下缘周长。140例桡骨头半脱位患儿分别采用极度旋前(n=70)、旋后(n=70)复位法进行治疗,比较其复位率和MOPS评分。结果桡骨头矢状径大于桡骨颈矢状径(P<0.05),桡骨头横径大于桡骨颈横径(P<0.05),而环状韧带上下缘周长接近。旋前复位组与旋后复位组在男女、左右手比例上差异无统计学意义(P>0.05)。旋前复位组首次复位率(95.7%)显著高于旋后复位组的82.9%(P<0.05)。旋前法MOPS评分低于旋后法[(4.17±1.35)分比(7.05±1.60)分,P<0.05]。结论环状韧带及关节囊嵌顿于肱桡关节间隙是桡骨头半脱位的解剖机制,在首次复位率、减轻疼痛方面极度旋前法优于旋后法。Objective To compare the hyperpronation and supination in the reduction of radial head subluxation through observing anatomical features and clinical efficacies.Methods Twenty infant embalmed cadaver elbows were dissected to measure the sagittal and transverse diameters of radial head and neck and the circumference of annular ligament.In addition,140children with radial head subluxation were treated with hyperpronation（hyperpronation group,n=70）or supination（supination group,n=70）.Reduction rate and MOPS score were compared between the two groups.Results The sagittal and transverse diameters of radial head were larger than those of radial neck（P＆lt;0.05）.However,the superior circumference of annular ligament was approximately similar to inferior circumference of annular ligament.No significant differences in male to female ratio and left hand to right hand ratio were found between hyperpronation group and supination group（P＆gt;0.05）.The success rate in hyperpronation group（95.7%）was significantly higher than that in supination group（82.9%）on the first attempt（P＆lt;0.05）.In addition,MOPS score in hyperpronation group（4.17±1.35）was significantly lower than that in supination group（7.05±1.60）（P＆lt;0.05）.Conclusion The interposition of annular ligament and joint capsule into humeroradial joint is the anatomical mechanisms of radial head subluxation.Hyperpronation is superior to supination for increasing success rate and alleviating pain in the reduction of radial head subluxation.

关 键 词：桡骨头半脱位 极度旋前复位 极度旋后复位 婴幼儿 

分 类 号：R726.8[医药卫生—儿科]