可吸收棒固定治疗儿童肱骨内上髁骨折  

Absorbable rods for fixation of medial humeral epicondyle fracture in children

作　　者：蓝吉斌[1] 邓洪辉[1] 宿玉玺[2] 覃佳强[2] 王忠良[2] 蔡文全[2] 南国新[2] 

机构地区：[1]南宁市第一人民医院小儿外科,061001 [2]重庆医科大学附属儿童医院骨二科、儿童发育疾病研究省部共建教育部重点实验室干细胞室、儿科学重庆市重点实验室、重庆市儿童发育重大疾病诊治与预防国际科技合作基地

出　　处：《中华创伤杂志》2014年第8期786-789,共4页Chinese Journal of Trauma

摘　　要：目的 探讨儿童肱骨内上髁骨折的有效治疗方法. 方法 选择2008年1月-2011年6月收治的25例儿童肱骨内上髁骨折患者,其中男18例,女7例;年龄7～ 14岁,平均11.4岁.合并伤：肘关节脱位7例,外髁骨折2例.按随机数字表法将患者分为肘内侧入路、切开复位、可吸收棒内固定组（A组,13例）和切开复位经皮克氏针固定组（B组,12例）.术后均采用石膏托固定.A组术后2～3周开始功能训练,B组术后4～6周有明显骨痂时开始功能训练,并定期随访. 结果 所有患者均获随访6 ～41个月,平均22个月.骨折愈合时间A组3～5周,平均3.8周;B组4～8周,平均5.6周.6个月后肘关节功能根据改良Bede评分标准：A组优10例,良3例,可0例,差0例,评分（93.7±3.3）分;B组优3例,良7例,可2例,差0例,评分（85.3±6.3）分（t=-4.24,P＜0.05）. 结论 切开复位可吸收棒内固定稳定性强、功能恢复好、并发症少,是治疗儿童肱骨内上髁骨折的理想方法.Objective To discuss the effective treatments for fracture of the medial humeral epicondyle in children. Methods Twenty-five children with fracture of the medial humeral epicondyle treated from January 2008 to June 2011 were studied, including 18 males and 7 females at age of 7-14 years （ mean, 11.4 years）. There were 7 cases accompanied with elbow joint dislocation and 2 lateral humeral epicondyle fracture. Patients were assigned to medial elbow approach to open reduction and internal fixation with absorbable rods （ Group A, n = 13） and open reduction and percutaneous K-wire fixation （ Group B, n = 12） according to the random number table. A plaster support was applied after surgery. Functional training was initiated 2-3 weeks after operation for Group A and 4-6 weeks after adequate callus formation for Group B. Moreover, follow-up was performed at regular intervals. Results All patients were followed up for 6-41 months （ mean, 22 months ）. Mean healing time was 3. 8 weeks （ range, 3-5 weeks） in Group A and 5.6 weeks （ range, 4-8 weeks ） in Group B. At postoperative 6 months, Bede elbow performance score was （93.7±3.3 ） points in Group A with 10 excellent and 3 good results and （85.3±6.3 ） points in Group B with 3 excellent, 7 good, and 2 fair results （ t = - 4.24, P 〈 0.05 ）. Condusion Open reduction and internal fixation with absorbable rods gains advantages of rigid immobilization, functional recovery and minor complication and hence is effective for treatment of medial humeral epicondyle fracture in children.

关 键 词：肱骨骨折 骨折固定术 内 儿童 

分 类 号：R726.8[医药卫生—儿科]