有限切开复位经皮克氏针内固定治疗儿童难复性Gartland Ⅲ型肱骨髁上骨折  

Limited Open Reduction and Kirschner Wire Fixation in treatment of Children with Refractory Gartland type Ⅲ Supracondylar Fracture of the Humerus

作　　者：林凯[1] LIN Kai(Hanchuan People's Hospital,Hubei Hanchuan 431600,China)

机构地区：[1]湖北省汉川市人民医院骨科,湖北汉川431600

出　　处：《河北医学》2018年第4期671-676,共6页Hebei Medicine

摘　　要：目的:观察有限切开复位经皮克氏针固定治疗儿童难复性GartlandⅢ型肱骨髁上骨折的临床效果。方法:2016年9月至2017年5月期间,对我院收治的80例儿童骨折患者进行临床对照研究,根据患者入院单双日均为实验组(闭合复位法)和对照组(有限切开复位法),每组均为40例患者,比较两组患者手术指标、治疗前后肘关节活动度、肘关节ROM评分、并发症等的统计学差异。结果:两组患者出院3个月临床疗效指标的差异具有统计学意义(P<0.05);两组患者住院时间、术后VAS评分、石膏固定时间指标的差异具有统计学意义(P<0.05),实验组各项指标均少于对照组;两组患者手术后(旋前)、出院时(屈曲、旋前、旋后)指标的差异具有统计学意义(P<0.05),实验组和对照组两组患者不同时点(屈曲、旋前、旋后)指标的差异具有统计学意义(P<0.05);两组患者出院时伸直痉挛、伸屈范围指标的差异具有统计学意义(P<0.05),实验组和对照组两组患者不同时点伸直痉挛、屈曲痉挛、伸屈范围指标的差异具有统计学意义(P<0.05);两组患者临床并发症肘内翻畸形、骨化性肌炎指标的差异具有统计学意义(P<0.05)。结论:有限切开复位经皮克氏针内固定治疗儿童难复性GartlandⅢ型肱骨髁上骨折相比闭合复位内固定术,其疗效安全有效,且在患者肢体功能恢复上具有一定临床优势。Objective:To observe the clinical effect of limited open reduction and percutaneous Kirschner wire fixation for the treatment of complex fractures of children with Gartland supracondylar humerus.Methods:During the September 2016 to May 2017,the clinical controlled study was conducted in 80 cases of fractures in children in our hospital,according to patients with single and double were as the experimental group(closed reduction method)and control group(limited open reduction method),40 patients in each group.The statistical difference between the two groups of surgical indexes,the activity of the elbow joint before and after treatment,the ROM score of the elbow joint,and the complications were compared.Results:The difference between the two groups was statistically significant(P<0.05).The difference between the two groups was statistically significant(P<0.05),and the experimental group was less than the control group.Two groups of patients after surgery(before),at discharge(buckling,pronation and supination)index differences statistically significant(P<0.05);the experimental group and control group two groups of patients with different time points(buckling,pronation and supination)index differences statistically significant(P<0.05);Two groups of patients discharged from hospital when unbend spasm,scope of flexed index differences statistically significant(P<0.05),the experimental group and control group two groups of patients with different point straight spasm,buckling cramps,scope of flexed index differences statistically significant(P<0.05);The difference between the two groups of patients was statistically significant(P<0.05).Conclusion:Limited open reduction and Kirschner wire fixation in treatment of children with complex compared to closed reduction and internal fixation of Gartland type III supracondylar fracture of the humerus,its curative effect is safe and effective,and patients in the recovery of limb function has certain clinical advantages.

关 键 词：肱骨髁上骨折 有限切开复位内固定术 闭合复位内固定术 

分 类 号：R726.8[医药卫生—儿科]