屈肘前臂旋前位整复伸直型小儿肱骨髁上骨折的疗效观察  

Efficacy analysis of immobilization in the elbow flexed forearm pronated position for extension type of pediatric supracondylar humeral fracture in children

作　　者：白雪[1] 

机构地区：[1]浙江省富阳市中医骨伤医院,杭州311400

出　　处：《浙江创伤外科》2014年第4期512-514,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的应用SPSS和EXCEL对小儿肱骨髁上骨折整复前后的桡尺侧移位值和Baumann角进行回归分析,以评价屈肘前臂旋前位整复伸直型小儿肱骨髁上骨折的疗效。方法收集2010年7月至2011年7月间,就诊的小儿肱骨髁上骨折56例,采用数据侧量工具MB-Ruler,测量各病例受伤后X线片骨折的移位值及Baumann角,将数值录入于Excel。然后使用屈肘前臂旋前位手法整复,摄片后同手法整复前处理,数据录入Excel。将数据分为4组:1整复前尺偏型;2整复后尺偏型;3整复前桡偏型;4整复后桡偏型。分别使用SPSS行回归分析,在EXCEL上合并拟合曲线进行对比分析。结果对比整复前后尺偏型骨折的情况得出,整复后尺偏型骨折减少了11例,尺偏系数较小了0.493,Baumann角减少了21°,且改变同样量的尺偏系数的情况下,整复后Baumann角度的变化量下降,稳定性增强。对比手法整复前后桡偏型骨折情况类似,桡偏系数减小,Baumann角减小,变化率下降,稳定性增高。结论屈肘前臂旋前位整复小儿肱骨髁上骨折减少尺偏病例,控制偏移距离,减小Baumann角,增强断端稳定性,可以有效地控制肘内翻畸形的发生。Objective To analysis efficacy of reduction and immobilization by elbow flexion pronation for extension type of pediatric supra-condylar humeral fracture by using SPSS and EXCEL through regression analysising about the deviation and Baumann angle before and after manipu-lative reduction. Methods From July 2010 to July 2011, 56 cases with pediatric supracondylar fractures were collected（ 3 to 14 years old, 34 boys and 22 girls, 15 patients with radial deviation and 41 patients with ulnar deviation）. The fracture displacement and Baumann angle before and after manipulative reduction was measured by MB-Ruler. All the data were divided into four groups： ulnar type, ulnar type after reduction, radial de-viation, radial deviation type after reduction, and regression analysis was processed by the SPSS and EXCEL. Results After reduction, the ulnar fracture reduced 11 cases, ulnar deviation coefficient reduced 0.493, Baumann reduced 21°, and the same change of ulnar deviation, the Baumann angle variation decreased which meanes the stability enhanced. The similar results happened in the radial type fracture, after reduction, the radial devia-tion coefficient decreased, Baumann angle decreased, the rate of change decreased and the stability increased. Conclusion Immobilization in the elbow- flexed-forearm-pronated position for humerus supracondylar extension type fracture reduced ulnar deviation cases, the deviation controlled,the Baumann angle decreased, the stability enhanced and cubitus varus deformity reduced.

关 键 词：屈肘前臂旋前 小儿 肱骨骨折 BAUMANN角 

分 类 号：R687.3[医药卫生—骨科学]