复位架牵引下手法复位经皮穿针内固定治疗儿童肱骨髁上骨折的临床研究  

Clinical study on reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation for treatment of humeral supracondylar fractures in children

作　　者：沈海[1] 刘昕[1] 彭玉兰[1] 乐劲涛 王英[1] 周英[1] 邓志强[1] 

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《中医正骨》2015年第10期1-4,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：四川省中医药管理局科研基金资助项目(2011SZ0251)

摘　　要：目的:观察复位架牵引下手法复位经皮穿针内固定治疗儿童肱骨髁上骨折的临床疗效。方法:将符合要求的60例肱骨髁上骨折患者随机分为复位架组和手法复位组,每组30例。复位架组采用复位架牵引下手法复位经皮穿针内固定治疗,手法复位组采用手法复位经皮穿针内固定治疗。比较2组患者的手术时间、住院时间、肘内翻发生率及临床疗效。临床疗效评价采用《中医病证诊断疗效标准》中肱骨髁上骨折的疗效标准。结果:复位架组的手术时间和住院时间均比手法复位组短[(33.73±10.33)min,(40.55±9.44)min,t=9.223,P=0.000;(13.95±2.96)d,(17.75±4.10)d,t=1.425,P=0.037]。术后6周时共有3例患者失访(复位架组1例、手法复位组2例),复位架组9例发生肘内翻、手法复位组15例发生肘内翻,2组患者肘内翻的发生率比较,差异无统计学意义(χ2=2.968,P=0.085);复位架组治愈20例、好转9例,手法复位组治愈13例、好转15例,2组患者的临床疗效比较,差异无统计学意义(Z=-1.708,P=0.088)。结论:复位架牵引下手法复位经皮穿针内固定术治疗儿童肱骨髁上骨折疗效确切,并可有效缩短手术时间及住院时间,值得临床推广应用。Objective： To observe the clinical curative effect of reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation in the treatment of humeral supracondylar fractures in children. Methods： Sixty patients with humeral supracondylar fractures enrolled in the study were randomly divided into reduction frame group and manipulative reduction group,30 cases in each group. The patients in reduction frame group were treated with reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation,while the others in manipulative reduction group were treated with manipulative reduction combined with percutaneous Kirschner wire internal fixation. The operative time,hospital stay,incidence rate of cubitus varus and clinical effects were compared between the 2 groups,and the curative effects were evaluated according to the therapeutic effect criterion of humeral supracondylar fracture which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Results： The operative time and hospital stay of reduction were shorter in reduction frame group compared to manipulative reduction group（ 33. 73 ＋/-10. 33 vs 40. 55 ＋/-9. 44 min,t =9. 223,P =0. 000; 13. 95 ＋/-2. 96 vs 17. 75 ＋/-4. 10 days,t =1. 425,P =0. 037）. One patient in reduction frame group and 2 patients in manipulative reduction group lost to follow- up 6 weeks after the operation,and cubitus varus were found in reduction frame group（ 9 cases） and manipulative reduction group（ 15 cases）. There was no statistical difference in the incidence rate of cubitus varus between the 2 groups（ χ^2= 2. 968,P = 0. 085）. Twenty patients obtained an excellent result and 9 good in the reduction frame group,while 13 patients obtained an excellent result and 15 good in the manipulative reduction group,and there was no statistical difference in the clinical curative effect between the 2 groups（ Z =- 1

关 键 词：肱骨骨折 正骨手法 牵引术 治疗 临床研究性 

分 类 号：R274.1[医药卫生—中医骨伤科学]