GartlandⅡ型儿童肱骨髁上骨折两种治疗方案的中远期临床疗效及影像学评价  

Medium and Long Term Clinical Efficacy and Imaging Evaluation of Two Treatments for Gartland TypeⅡSupracondylar Humerus Fractures in Children

作　　者：余泽俊 黄文凭[1] 苏松川[1] 童庭 彭正刚[1] Yu Zejun;Huang Wenping;Su Songchuan;Tong Ting;Peng Zhenggang(Chongqing Orthopaedic Hospital of Traditional Chinese Medicine, Chongqing 400010, China)

机构地区：[1]重庆市中医骨科医院,重庆400010

出　　处：《成都医学院学报》2022年第1期43-47,共5页Journal of Chengdu Medical College

基　　金：重庆市医学科研项目(No:20142151)。

摘　　要：目的对比两种不同治疗方案治疗GartlandⅡ型儿童肱骨髁上骨折的中远期临床疗效和影像学评价结果。方法选取2016年1月至2020年6月重庆市中医骨科医院收治的101例GartlandⅡ型儿童肱骨髁上骨折患者为研究对象,根据自愿及随机对照原则,分为试验组(闭合复位+克氏针穿针外固定,52例)和对照组(闭合复位+石膏托外固定,49例)。于末次随访时(末次随访时间至少≥1年)测量并比较两组一般资料、Flynn标准疗效评定结果、Mayo功能评分、Baumann角(B角)、携带角(C角)、前肱骨线(是否通过肱骨小头的中1/3)、安全性检测结果与评价。结果两组B角、C角、前肱骨线等影像资料比较差异无统计学意义(P>0.05)。两组肘关节Mayo功能评分比较差异有统计学意义(P<0.05)。两组Flynn标准疗效评定结果比较差异无统计学意义(P>0.05)。两组肘内翻发生率比较差异有统计学意义(P<0.05)。两组肘外翻、感染、尺神经损伤、肘关节僵硬、肘部骨化性肌炎发生率比较差异无统计学意义(P>0.05)。结论闭合复位+克氏针穿针外固定治疗GartlandⅡ型儿童肱骨髁上骨折具有操作简单、固定牢靠、恢复快、疗法安全有效等优点。Objective To compare the medium and long term clinical efficacy and imaging evaluation of two different treatment schemes for Gartland typeⅡsupracondylar humerus fractures in children.Methods A total of 101 children with Gartland typeⅡsupracondylar humerus fracture treated in Chongqing Orthopaedic Hospital of Traditional Chinese Medicine from January 2016 to June 2020 were selected.According to the wishes of patients and the principle of randomized control,the patients were divided into experimental group(closed reduction+external fixation with Kirschner wire,n=52)and control group(closed reduction+external fixation with plaster cast,n=49).At the last follow-up(at least≥1 year after treatment),the corresponding indicators of the two groups were measured,recorded and compared,including(1)general data;(2)Flynn efficacy evaluation criteria;(3)Mayo elbow performance score(MEPS);(4)Baumann Angle(B Angle);(5)Carrying Angle(C Angle);(6)Anterior humeral line(whether it passes through the middle 1/3 of the humeral capitulum);(7)safety test results and evaluation.Results There was no significant difference in B Angle,C Angle,and anterior humeral line between the two groups(P>0.05).There was significant difference in MEPS between the two groups(P<0.05).There was no significant difference in Flynn efficacy evaluation criteria between the two groups(P>0.05).As to complications,there was significant difference in the occurrence of cubital varus between the two groups(P<0.05),while there was no significant difference in the occurrence of elbow valgus,infection,ulnar nerve injury,elbow stiffness and elbow ossifying myositis between the two groups(P>0.05).Conclusion Closed reduction combined with external fixation with Kirschner wire for the treatment of Gartland typeⅡsupracondylar humerus fractures in children has the advantages of simple operation,firm fixation,quick recovery,safety and effectiveness,and is worthy of clinical application.

关 键 词：儿童肱骨髁上骨折 闭合复位 石膏 克氏针 疗效 

分 类 号：R726.8[医药卫生—儿科]