闭合与切开复位克氏针内固定治疗小儿肱骨髁上骨折的效果比较  

Comparison of effects of closed reduction and open reduction with Kirschner wire internal fixation in treatment of children with supracondylar fractures of humerus

作　　者：杨海宝[1] 汤奇[1] 陈广辉[1] 高锋[1] 殷浩荣 YANG Haibao;TANG Qi;CHEN Guanghui;GAO Feng;YIN Haorong(Department of Orthopaedics of Donghua Hospital,Dongguan 523110 Guangdong,China)

机构地区：[1]东莞东华医院骨科,广东东莞523110

出　　处：《中国民康医学》2020年第23期128-130,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较闭合与切开复位克氏针内固定治疗小儿肱骨髁上骨折的效果。方法:回顾性分析2018年1月至2019年9月58例肱骨髁上骨折患儿的临床资料,按照治疗方法不同分为观察组与对照组各29例。观察组采用闭合复位克氏针内固定治疗,对照组采取切开复位克氏针内固定术治疗,比较两组临床疗效、手术相关指标、术后康复指标、疼痛评分、肘关节功能评分及并发症发生率。结果:两组治疗优良率比较,差异无统计学意义(P>0.05);观察组住院时间、石膏拆除时间、克氏针取出时间、骨折愈合时间均短于对照组,术中出血量低于对照组,手术时间长于对照组,差异有统计学意义(P<0.05);观察组术后1 d、3 d、1个月、3个月时疼痛评分及并发症发生率均低于对照组,差异有统计学意义(P<0.05);观察组肘关节功能评分高于对照组,差异有统计学意义(P<0.05)。结论:闭合复位克氏针内固定治疗小儿肱骨髁上骨折,疗效与切开复位内固定手术相当,但有利于肘关节功能恢复,能降低术后疼痛和并发症发生率,具有更高的安全性。Objective:To compare effects of effects of closed reduction and open reduction with Kirschner wire internal fixation in treatment of children with supracondylar fractures of humerus.Methods:Retrospective analysis of clinical data of 58 children with supracondylar fractures of humerus from January 2018 to September 2019.According to different treatment methods,they were divided into observation group and control group,29 cases in each.The observation group was treated with closed reduction and Kirschner wire internal fixation,while the control group was treated with open reduction and Kirschner wire internal fixation.The curative effects,surgical indexes,postoperative rehabilitation indexes,pain score,elbow function score and complication rate were compared between the two groups.Results:There was no statistically significant difference in the excellent and good rate of treatment between the two groups(P>0.05).The hospitalization time,plaster removal time,Kirschner wire removal time,and fracture healing time of the observation group were shorter than those of the control group;the intraoperative blood loss was less than that of the control group,the operation time was longer than that of the control group;and the differences were statistically significant(P<0.05).The pain scores and complication rates of the observation group 1 d,3 d,1 month,and 3 months after the surgery were lower than those of the control group,and the differences were statistically significant(P<0.05).Further,the function score of the elbow joint in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Closed reduction and Kirschner wire internal fixation in the treatment of humeral supracondylar fractures in the children has the same effects as open reduction internal fixation.Moreover,it is beneficial to the recovery of the elbow joint function,and can reduce the incidence of postoperative pain and complications,with higher safety.

关 键 词：小儿 肱骨髁上骨折 闭合复位 切开复位 克氏针内固定术 

分 类 号：R683.41[医药卫生—骨科学]