闭合复位内固定治疗小儿肱骨髁上骨折的临床疗效分析  

Clinical analysis on the effect of closed reduction and internal fixation in the treatment of supracondylar fracture of humerus in children

作　　者：刘智深 牛志勇 田少斌 

机构地区：[1]晋城大医院骨科一病区,山西晋城048006

出　　处：《中国现代医生》2017年第6期71-74,共4页China Modern Doctor

摘　　要：目的探讨闭合复位内固定治疗儿童肱骨髁上骨折的临床疗效,并与切开复位内固定的疗效进行比较。方法 2014年1月~2016年1月我院收治小儿肱骨髁上骨折患者102例,其中52例用闭合复位经皮克氏针内固定治疗(观察组),50例采用切开复位内固定治疗(对照组),比较两组的治疗效果及并发症情况。结果随访6个月,两组患者术后肘关节优良率及术后并发症比较,差异无统计学意义,两组疗效及并发症相当。但两组的手术时间、术中出血量及骨折愈合时间有统计学差异,观察组手术时间、出血量较对照组明显减少,骨折愈合时间较对照组明显缩短。两组术后8 h、24 h和72 h疼痛评分有统计学差异,对照组疼痛程度明显较观察组严重。术后72 h两组疼痛轻微或无明显疼痛。各组内随着术后时间的延长,疼痛逐步减轻。结论闭合复位内固定术治疗小儿肱骨髁上骨折手术时间短、术中出血少、骨折愈合时间短、手术创伤小、术后疼痛轻微、固定可靠,手术时可优先行闭合复位内固定术,再考虑切开复位内固定术。Objective To investigate the clinical efficacy of closed reduction and internal fixation in the treatment of supracondylar fracture of humerus in children, and to compare with the effect of open reduction and internal fixation. Mehods 102 patients with supracondylar fractures of the humerus admitted in our hospital from January 2014 to January 2016 were enrolled. Among them, 52 patients were treated with closed reduction and Kirschner wire fixation （observation group）. 50 patients were given open reduction and internal fixation treatment（control group）, and the treatment effect and complications between the two groups were compared. Results The follow-up time was 6 months. There was no significant difference in the excellent rate of postoperative elbow flexion and postoperative complications between the two groups. The efficacy and complication of the two groups were similar. But the operation time, intraoperative blood loss and fracture healing time were statistically different between the two groups. The time of operation and the amount of bleeding in the observation group were significantly lower than those in the control group. The time of fracture healing was shorter than that of the control group. There were significant differences in pain scores between the two groups at 8 hours, 24 hours and 72 hours. The degree of pain in the control group was significantly higher than that in the observation group.72 hours after surgery, the two groups had mild or no pain.With the postoperative time, the pain gradu- ally reduced in each group. Conclusion Closed reduction and internal fixation is applied for the treatment of supra- condylar fracture of humerus in children, with short the operation time, little intraoperative bleeding, short fracture time, small surgical trauma, mild postoperative pain and reliable fixation. Closed reduction and internal fixation can be performed preferentially, and then the reduction and internal fixation is considered at surgery.

关 键 词：肱骨髁上骨折 闭合复位 切开复位 克氏针内固定 

分 类 号：R726.8[医药卫生—儿科]