正骨手法联合关节造影术治疗JakobⅡ型儿童肱骨外髁骨折临床分析  

Clinical analysis of manual reduction combined with arthrography in the treatment of Jakob typeⅡhumeral lateral condyle fractures in children

作　　者：吕辰玮 林伟栋 沈鸿辉 庄志强 刘海清 LV Chenwei;LIN Weidong;SHEN Honghui;ZHUANG Zhiqiang;LIU Haiqing(Department of Orthopaedics,Zhangzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine,Zhangzhou,Fujian 363000,China)

机构地区：[1]福建中医药大学附属漳州中医院骨伤科,福州350007

出　　处：《福建医药杂志》2021年第4期11-14,共4页Fujian Medical Journal

基　　金：2017年福建省卫生计生青年科研课题立项(2017-2-65);漳州市中医重点专科建设项目资助。

摘　　要：目的探讨正骨手法联合关节造影术对JakobⅡ型儿童肱骨外髁骨折的临床疗效。方法选取我院收治的61例JakobⅡ型肱骨外髁骨折的患儿,随机分为观察组(30例)和对照组(31例)两组。观察组采用手法整复经皮克氏针固定,并在术中以关节造影进行评估;对照组采用切开复位克氏针固定。比较两组的术中出血量、手术时间、住院天数、术后早期疼痛程度、骨折愈合情况、肘关节功能优良率。结果所有患者在术后6周均达骨折临床愈合标准。两组均未发生骨骺早闭、缺血性骨坏死、肘外翻畸形等并发症。术后8周行Mayo评分,观察组的优良率高于对照组,差异有统计学意义(P<0.05)。观察组的术中出血量、手术时间、住院天数、术后早期疼痛评分均低于对照组,差异有统计学意义(P<0.05)。结论治疗JakobⅡ型儿童肱骨外髁骨折,采用闭合整复经皮穿针固定联合关节造影术的方法,具有创伤小、失血少、疼痛程度低、关节功能恢复快的优点,并在骨折愈合和畸形预防方面,能够与传统的切开复位手术达到相同的效果。Objective To observe the clinical effect of manual reduction combined with arthrography in the treatment of Jakob typeⅡhumeral lateral condylar fracture in children.Methods A total of 61 children with Jakob typeⅡhumeral lateral condylar fracture from February 2017 to July 2020 were selected and randomly divided into two groups.A total of 30 cases in the experimental group were treated with manipulative reduction and percutaneous Kirschner wire fixation,and evaluated by arthrography during the operation.A total of 31 cases in the control group were treated with open reduction and Kirschner wire fixation.The intraoperative blood loss,operation time hospitalization days,early postoperative pain,fracture healing condition and excellent and good rate of elbow function were compared between the two groups.Results All cases reached the standard of fracture healing 6 weeks after operation.There were no complications such as premature epiphyseal closure,ischemic osteonecrosis,cubitus valgus deformity in both groups.Mayo score was performed 8 weeks after operation.The excellent and good rate of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).The intraoperative blood loss,operation time,hospitalization days and early postoperative pain score of the experimental group were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclution For the treatment of Jakob typeⅡchildren’s humeral lateral condyle fracture,closed reduction and percutaneous Kirschner wire fixation method has the advantages of less trauma,less blood loss,low degree of pain and quick recovery of joint function,and can achieve the same effect as traditional open reduction and kirschner wire fixation in fracture healing and deformity prevention.

关 键 词：肱骨外髁 正骨手法 关节造影术 克式针 儿童 

分 类 号：R681.7[医药卫生—骨科学]