儿童Gartland Ⅲ型肱骨髁上骨折矫枉过正后的远期疗效评价  

Long-term follow-up results evaluation of overcorrecting in the treatment of Gartland type Ⅲ supracondylar fracture of humerus in children

作　　者：龙千里 姬芝栩 龙征忠 张臻福 LONG Qianli;JI Zhixu;LONG Zhengzhong;ZHANG Zhengfu(Taijiang County People′s Hospital,Taijiang 556300,China;Taijaing County National Hospital,Taijiang 556300,China)

机构地区：[1]台江县人民医院,贵州台江556300 [2]台江县民族医院,贵州台江556300

出　　处：《临床医药实践》2018年第10期736-739,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨儿童GartlandⅢ型肱骨髁上骨折在整复、固定、功能康复锻炼中采用矫枉过正法对远期疗效的影响。方法:回顾性分析1992年5月—2012年12月采用矫枉过正法进行治疗的160例儿童肱骨髁上骨折的临床资料和随访结果,闭合复位与切开复位各80例,男128例,女32例,年龄(6. 7±1. 7)岁对其功能恢复、携带角改变等进行统计分析。结果:随访(9. 4±3. 7)年,肘关节屈伸范围(134. 9±4. 6)°。有93例携带角减少,发生临床肘内翻6例,肘内翻角度(5. 3±2. 6)°。闭合复位与切开复位发生携带角减少、肘内翻发生率比较,差异无统计学意义,但对肘关节屈伸功能的影响,手术患者大于非手术患者。结论:矫枉过正可减少携带角丢失的发生率,减轻肘内翻的发生程度,切开复位对患儿肘关节的屈伸功能有一定影响,GartlandⅢ型儿童肱骨髁上骨折采用闭合复位后石膏固定仍是简便有效的方法,更具优势。Objective：To investigate the clinical effect of the overcorrection method on the supracondylar fracture of humerus in children during the redution,fixation and functional rehabilitation exercises.Methods：The clinical data and the follow-up results of 160 cases of Gartland type Ⅲ supracondylar fracture of humerus in children admitted from May 1992 to December 2012 were analyzed retrospectively,there were 80 cases of closed reduction and open reduction,including 128 males and 32 females,the mean age was （6.7±1.7） years,and were treated with overcorrection.The functional recovery of elbow joint and the carry angle change were analyzed statistically.Results：The average length of follow-up was （9.4±3.7） years.Elbow flexion and extension were （134.9±4.6） degrees.There were 93 cases with angle reduction,6 cases of clinical cubitus varus,and the mean cubitus varus angle was （5.3±2.6） degrees.There is no statistical difference between closed reduction and open reduction in reduction of the angle of carriage and cubitus varus,but the effect on elbow flexion and extension is greater than that of nonoperative treatment.Conclusion：Overcorrection can reduce the incidence ofcarrying angle loss,reduce the occurrence degree of cubitus varus.Open reduction of children with elbow flexion and extension function has certain effect,Gartland type Ⅲ supracondylar fracture of humerus in children with closed reduction and plaster fixation is still a simple and effective method,and has more advantages.

关 键 词：肱骨髁上骨折 肘内翻 矫枉过正 闭合复位 切开复位 石膏固定 克氏针交叉固定 

分 类 号：R726.8[医药卫生—儿科]