两种置针方式治疗儿童肱骨髁上骨折的疗效比较  

Eeffect comparison of two kinds of wire placement methods on humeral supracondylar fracture in children

作　　者：田野[1] TIAN Ye(Dept of Pediatric Orthopaedics,Shenyang Orthopaedic Hospital,Shenyang,Liaoning 110044,China)

机构地区：[1]沈阳市骨科医院小儿骨科,辽宁沈阳110044

出　　处：《临床骨科杂志》2021年第6期841-844,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较内外侧交叉置针与桡侧平行置针治疗儿童肱骨髁上骨折的疗效。方法将88例儿童肱骨髁上骨折患儿按照置针方式的不同分为A组(采用内外侧交叉置针固定,44例)和B组(采用桡侧平行置针固定,44例)。比较两组手术时间、骨折临床愈合时间、肘关节活动度、并发症发生情况。采用Flynn肘关节功能评定标准评价疗效。结果患儿均获得随访,时间6~12(8.6±1.2)个月。手术时间、骨折临床愈合时间B组均明显短于A组(P<0.05)。A组2例术中出现医源性尺神经损伤,术后及时拔除克氏针后逐渐恢复;两组均未发生肘内外翻畸形、复位丢失、感染等并发症。术后6个月肘关节屈曲、伸直活动度两组比较差异均有统计学意义(P<0.05)。末次随访时采用Flynn肘关节功能评定标准评价的优良率B组明显高于A组(P<0.05)。结论采用内外侧交叉置针及桡侧平行置针治疗儿童肱骨髁上骨折均具有微创、固定可靠、并发症少等优点,但桡侧平行置针手术时间更短、手术操作更简单、骨折临床愈合时间更短、术后患儿功能恢复更快。Objective To compare the curative effect of medial-lateral crossed wire placement and parallel radial wire placement in the treatment of humeral supracondylar fracture in children.Methods The 88 children with humeral supracondylar fractures were divided into group A(44 cases were fixed with medial-lateral crossed wire placement)and group B(44 cases were fixed with parallel radial wire placement),according to different wire placement methods.The operation duration,fracture clinical healing time,the activity range of eblow joint and complication incidence situaiton were compared,and the efficay was assessed by Flynn elbow joint fucnction criterion.Results All the children were followed up for 6~12(8.6±1.2)months.The operative time and clinical healing time of group B were significantly shorter than those of group A(P<0.05).Intraoperative iatrogenic ulnar nerve injury occurred in 2 cases of group A,which recovered gradually after timely removal of Kirschner wire.None of the patients had cubitus varus,reduction loss,infection and other complications.At 6 months postoperation,there were statistically significant differences in the flexion and extension range of eblow motion between the two groups(P<0.05).At the last follow-up,the excellent and good rate of Flynn elbow function assessment standard in group B was significantly higher than that in group A(P<0.05).Conclusions Medial-lateral crossed wire placement and closed reduction of parallel radial placement on humeral supracondylar fracture has the advantages of minimally invasive,reliable fixation,few complications,but the latter has shorter operation time,simpler operation,shorter clinical healing time and faster postoperative functional recovery.

关 键 词：闭合复位 桡侧平行置针 内外侧交叉置针 儿童 肱骨髁上骨折 

分 类 号：R683.41[医药卫生—骨科学] R687.32[医药卫生—外科学]