肘前微创入路结合提按手法治疗儿童Gartland Ⅲ型肱骨髁上骨折33例疗效观察  

Clinical observation of anterior cubital minimally invasive approach combined with lifting manipulation in treating 33 cases of children Gartland type Ⅲ supracondylar fracture of humerus

作　　者：曹锐 杨锐 冉彦夫 Cao Rui;Yang Rui;Ran Yanfu

机构地区：[1]重庆市万州区中医院,重庆404000

出　　处：《中医临床研究》2021年第9期127-128,共2页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨采用肘前入路结合提按手法治疗儿童难复性肱骨髁上骨折的临床疗效和经验。方法:对重庆市万州区中医院33例GartlandⅢ型肱骨髁上骨折患者:男性22例,女性11例;年龄3~14岁,采用肘前入路微创切开结合中医提按手法复位经皮交叉克氏针内固定,术后2周开始屈伸肘训练,术后4周拔除克氏针,指导功能练习。结果:33例中27例在门诊得到大于1年的随诊,随访8~21个月(平均12个月),所有病例3个月内全部骨折愈合并恢复肘关节正常活动范围,未发生肘内、外翻畸形和前臂缺血性肌挛缩等并发症。结论:肘前微创入路损伤小,能直接清晰显露骨折端,结合中医提按手法可以对骨折进行有效复位和固定,治疗效果好,是治疗儿童难复性肱骨髁上骨折的好方法。Objective: To explore the clinical effect and experience of anterior cubital minimally invasive approach combined with lifting manipulation in treating children Gartland type Ⅲ supracondylar fracture of humerus. Methods: 33 cases of Gartland type Ⅲsupracondylar fracture of humerus treated in Chongqing Wanzhou District Hospital of Traditional Chinese Medicine, including 22 males and 11 females, aged 3-14 years old, were treated with anterior cubital minimally invasive approach combined with lifting manipulation and percutaneous cross Kirschner wire internal fixation. Elbow flexion and extension training was started 2 weeks after operation,Kirschner wire was removed 4 weeks after operation to guide functional practice. Results: 27 of the 33 cases were followed up for more than one year in the outpatient department. All cases were followed up for 8-21 months(average 12 months). Within three months, all the fractures recovered and regained the normal range of elbow joint activity. No complications such as cubitus varus, cubitus valgus deformity and forearm ischemic muscle contracture occurred. Conclusion: Anterior cubital minimally invasive approach can show the fracture end directly and clearly, and it can effectively reduce and fix the fracture with the combination of Chinese medicine manipulation.It is a good method for the treatment of children’s refractory supracondylar fracture of humerus.

关 键 词：提按手法 肘前入路 肱骨髁上骨折 

分 类 号：R726.8[医药卫生—儿科]