3种手术入路治疗儿童肱骨髁上骨折疗效比较  

Compare Curait ve Effect on Three Surgical Approaches Treating Supracondylar Fracture of Humerus in Children

作　　者：王远辉[1] 万永鲜[1] 叶里子[1] 罗雷茗[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000

出　　处：《中国伤残医学》2016年第7期2-4,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：比较3种手术入路治疗儿童肱骨髁上骨折疗效差异。方法2：007年1月～2013年1月，246例肱骨髁上骨折患儿分为3组，分别应用外侧入路、内侧入路和改良外侧入路治疗。通过手术前、后肘关节运动范围和肘内翻发生率进行疗效评价，并对结果进行统计学分析。结果：全部病例都获得随访，时间6～36个月，平均18个月。3组治疗结果比较无显著性差异（ x2＝1．8081， P ＞0．05）。结论：外侧入路简单易行，创伤小，安全性较高，肘关节功能恢复快，但骨折复位较困难，伴尺神经损伤时不选用；内侧入路创伤小，恢复效果好，切口隐密、美观，骨折复位较外侧入路容易，固定效果可靠，可探查正中神经、尺神经；改良外侧入路操作简易、骨折复位、固定直观方便，手术创伤不大，关节功能恢复好。3种手术入路疗效相当，各有优劣，可根据患儿骨折情况和医生的技能及手术习惯加以选择。Objective：To compare the curative effects of three kinds of fracture operation approach for the treatment of humeral supra -condylar .Methods：From 2007 January to 2013 January , 246 cases of humeral supracondylar fractures were divided into three groups , re-spectively , the application of lateral approach , the medial approach and modified lateral approach for the treatment of .Through the opera-tion before, after the elbow range of motion and the incidence of cubitus varus efficacy was evaluated , and the results were statistically an-alyzed.Results：All cases were followed up , time 6 ~36 months, average 18 months.The results of treatment in the 3 groups were no significant difference （X2=1.8081, P ＞0.05）.Conclusion： Lateral approach is simple, small trauma, high safety, the elbow joint function recovered quickly , but the reduction of the fracture is difficult , not to use with ulnar nerve injury;the medial approach of small trauma, recovery effect is good, the incision hidden, appearance, fracture reduction than the lateral approach is easy , reliable fixation, exploration center nerve , ulnar nerve;improved lateral approach operation simple , fracture reduction , fixation and visual and convenient＆amp;nbsp;operation, little trauma, joint function recovered well .3 kinds of operation approach curative effect quite , each has advantages and disad-vantages, according to the children of fracture operation skills and habits and doctors to be chosen .

关 键 词：肱骨髁上骨折 手术入路 儿童 

分 类 号：R683.41[医药卫生—骨科学]