有限切开复位治疗儿童肱骨远端全骨骺分离的疗效研究  

Study on the limited open reduction in the treatment of distal humeral epiphyseal separation in children

作　　者：黄南翔 王鹏礼 曹豫江[2] HUANG Nanxiang;WANG Pengli;CAO Yujiang(Department of Pediatric Surgery,Nanchong Central Hospital/the Second Clinical Medical College of North Sichuan Medical College,Nanchong,Sichuan 637000,China;Department of Orthopaedics,Children′s Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]四川省南充市中心医院/川北医学院第二临床医学院小儿外科,637000 [2]重庆医科大学附属儿童医院骨一科,400016

出　　处：《重庆医学》2021年第3期432-435,439,共5页Chongqing medicine

基　　金：四川省科技厅应用基础研究项目(2018JY0100)。

摘　　要：目的探讨有限切开复位克氏针内固定治疗儿童肱骨远端全骨骺分离的临床疗效。方法回顾性分析南充市中心医院2010年5月至2017年10月肱骨远端全骨骺分离20例患儿的临床资料,按Delee分型:A型15例、B型4例、C型1例。10例采用有限切开复位克氏针内固定(有限切开复位组),10例采用手法复位石膏外固定治疗(手法复位组),术后定期随访行相关影像学检查,并进行肘关节功能评分。结果两组骨折愈合好,无切口感染、神经血管损伤等并发症发生。有限切开复位组与手法复位组肘关节提携角[(7.8±1.5)°vs.(0.5±0.2)°]比较,差异有统计学意义(P<0.05)。肘关节功能评价采用Flynn标准,有限切开复位组与手法复位组优良率(90%vs.70%)比较,差异有统计学意义(P<0.05)。结论有限切开复位治疗肱骨远端骨骺分离是一种较好的治疗选择。Objective To investigate the clinical outcomes of limited open reduction and Kirschner wire internal fixation in the treatment of distal humeral epiphyseal separation in children.Methods From May 2010 to October 2017,20 cases with distal humeral epiphyseal separation were received and cured.According to the Delee standards,there were 15 cases of type A,4 cases of type B and 1 case of type C.10 cases were treated using limited open reduction and Kirschner wire internal fixation(the limited open reduction group)and 10 cases were treated using conservative treatment(the manual reduction group).Radiological outcomes and elbow joint function scores were measured after operation and during the follow-up period.Results The fractures in the two groups healed well,and no complications such as wound infection and neurovascular injury occurred.Compared the elbow lifting angle in the limited open reduction group and the manual reduction group[(7.8±1.5)°vs.(0.5±0.2)°],the difference was statistically significant(P<0.05).Flynn standard was used to evaluate elbow joint function,there was a statistically significant difference of the excellent and good rate(90%vs.70%)between the limited open reduction group and the manual reduction group(P<0.05).Conclusion Limited open reduction is effective treatment for distal humeral epiphyseal separation.

关 键 词：肱骨 骨骺脱离 切开复位 克氏针 内固定 治疗结果 

分 类 号：R726.8[医药卫生—儿科]