早期手术与延迟手术治疗儿童GartlandⅢ型肱骨髁上骨折疗效比较  

Comparison of the effect of early surgery and delayed surgery in the treatment of children with Gartland type Ⅲ supracondylar humeral fracture

作　　者：王标[1] 孙克明 李振威 郭占豪 孙维胜 WANG Biao;SUN Keming;LI Zhenwei;GUO Zhanhao;SUN Weisheng(Department of Osteology,Children′s Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学附属儿童医院骨科,河南郑州450000

出　　处：《新乡医学院学报》2022年第3期228-231,共4页Journal of Xinxiang Medical University

摘　　要：目的比较早期手术与延迟手术治疗儿童GartlandⅢ型肱骨髁上骨折(SHF)的临床效果。方法选择2018年3月至2020年9月郑州大学附属儿童医院收治的92例GartlandⅢ型SHF患儿为研究对象,所有患儿行闭合或切开复位外侧入路扇形克氏针内固定术,根据手术时机将患儿分为早期手术组(受伤至手术时间<24 h,n=51)和延迟手术组(受伤至手术时间≥24 h,n=41)。记录并比较2组患儿的手术时间、闭合转切开复位例数及术中拍X线片次数。术后1 a,测量2组患儿患肢与对侧健肢肘关节活动度、Baumann角和提携角,对2组患儿的肘关节功能进行Mayo肘关节功能量表(MEPS)评分和Flynn评分,依据Flynn评分判定2组患儿的临床疗效。观察2组患儿并发症发生情况。结果早期手术组患儿中术中闭合转切开复位1例(1.96%),延迟手术组患儿中术中闭合转切开复位1例(2.44%),2组患儿术中闭合转切开复位率比较差异无统计学意义(χ^(2)=0.667,P>0.05)。早期手术组和延迟手术组患儿术中拍X线片次数分别为(15.2±3.1)、(16.4±3.5)次,2组患儿术中拍X线片次数比较差异无统计学意义(t=0.535,P>0.05)。早期手术组和延迟手术组患儿手术时间分别为(31.2±5.4)、(33.5±5.2)min,2组患儿手术时间比较差异无统计学意义(t=0.512,P>0.05)。术后1 a,2组患者健侧和患侧肘关节活动度、Baumann角、提携角比较差异均无统计学意义(P>0.05)。术后1 a,早期手术组和延迟手术组患儿肘关节功能MEPS评分分别为(95.1±2.5)、(92.6±3.5)分,2组患儿肘关节功能MEPS评分比较差异无统计学意义(t=0.653,P>0.05)。早期手术组和延迟手术组患儿临床疗效优良率分别为92.0%(47/51)、90.2%(37/41),2组患儿临床疗效优良率比较差异无统计学意义(χ^(2)=0.751,P>0.05)。早期手术组和延迟手术组患儿并发症发生率分别为1.96%(1/51)、2.44%(1/41),2组患儿并发症发生率比较差异无统计学意义(χ^(2)=0.873,P>0.05)。Objective To compare the clinical effect of early surgery and delayed surgery in the treatment of children with Gartland typeⅢsupracondylar humeral fracture(SHF).Methods A total of 92 children with Gartland typeⅢSHF admitted to the Children′s Hospital Affiliated to Zhengzhou University from March 2018 to September 2020 were selected as the research subjects.All children underwent closed or open reduction and lateral approach fan-shaped Kirschner wire internal fixation,and the children were divided into early operation group(the time from injury to surgery<24 hours,n=51)and delayed operation group(the time from injury to surgery≥24 hours,n=41)according to the timing of surgery.The operation time,the number of closed to open reduction and the number of X-rays taken during operation were recorded and compared between the two groups.One year after operation,the motion of the elbow joint,Baumann angle and carrying angle of the affected limb and the contralateral healthy limb of the children in the two groups were measured;the elbow function of the children in the two groups was evaluated by Mayo elbow performance score(MEPS)and Flynn score,and the clinical effect of children in the two groups was evaluated according to Flynn score.The complications of children in the two groups were observed.Results One case(1.96%)in the early operation group was converted from closed to open reduction,and one case(2.44%)in the delayed operation group was converted from closed to open reduction,there was no significant difference in the rate of closed-to-open reduction between the two groups(χ^(2)=0.667,P>0.05).The number of intraoperative X-rays irradiation in the early operation group and the delayed operation group was(15.2±3.1)and(16.4±3.5)times,respectively;and there was no significant difference in the number of intraoperative X-rays irradiation between the two groups(t=0.535,P>0.05).The operation time of the children in the early operation group and the delayed operation group was(31.2±5.4)and(33.5±5.2)minutes,resp

关 键 词：GartlandⅢ型肱骨髁上骨折 早期手术 延迟手术 儿童 

分 类 号：R683.41[医药卫生—骨科学]