手法复位纸抱壳夹板固定治疗内收型儿童肱骨外科颈骨折  

Manipulative Reduction and Paper Embracing Splint Fixation in the Treatment of Adduction type Fracture of Surgical Neck of Humerus in Children

作　　者：陈若晨 高志涛 胥智勇 CHEN Ruo-cheng;GAO Zhi-tao;XU Zhi-yong(Tianquan county TCM hospital famous TCM inheritance studio,Yaan city,Sichuan province 625599)

机构地区：[1]天全县中医医院名中医传承工作室,四川天全625599

出　　处：《中国伤残医学》2022年第7期24-27,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨手法复位陈氏特色纸抱壳夹板固定治疗内收型儿童肱骨外科颈骨折的临床疗效和安全性。方法:选择我院2018年1月-2019年12月,采用折顶手法复位纸抱壳夹板固定治疗肱骨外科颈骨折患儿52例。男39例,女13例;年龄5-14岁,中位数10岁;左侧24例,右侧28例。在牵引状态下,采用折顶手法复位骨折后,用陈氏特色纸抱壳夹板固定。观察骨折复位情况,随访观察骨折愈合、并发症发生情况及肩关节功能恢复。结果:49例患儿骨折1次复位成功。2例患儿复位后位置不理想,当天再次复位后固定;1例患儿复位后位置不理想,当天再次复位后换用陈氏特色纸抱壳夹板+小夹板+外展90°位石膏固定。患儿均获随访,随访时间3-24个月,中位数为4.5个月;骨折均愈合,愈合时间4-6周,中位数为4.5周。3个月时根据neer功能评分系统评定肩关节功能恢复情况。本组优42例、良8例、中2例,优良率为96.15%。有2例患者在治疗过程中出现骨折再移位,因移位程度不大,均未再次复位;所有患者无再骨折、骨筋膜室综合征、缺血性肌挛缩及神经、血管损伤等并发症发生。结论:折顶手法复位陈氏特色纸抱壳夹板固定治疗儿童肱骨外科颈骨折,骨折复位好,固定可靠,有利于骨折愈合和肩关节功能恢复,且并发症少。Objective:To investigate the clinical efficacy and safety of manipulative reduction and Chens characteristic paper embracing splint fixation in the treatment of adductive humeral surgical neck fractures in children.Methods:From January 2018 to December 2019,52 children with humeral surgical neck fracture were treated with folding top manipulative reduction and paper embracing splint fixation.There were 39 males and 13 females with a median age of 10 years(range,5-14 years).There were 24 cases on the left side and 28 cases on the right side.In the traction state,after the fracture was reduced by the method of breaking the top,it was fixed with Chens characteristic paper embracing splint.Observe the fracture reduction,follow-up observation of fracture healing,incidence and shoulder function recovery.Results:49 cases of fracture were successfully reduced at one time.2 cases were not in ideal position after reduction,and were fixed after re reduction on the same day;1 case was not ideal after reduction,and was fixed with Chens characteristic paper splint+small splint+abduction 90 degree plaster fixation.All the patients were followed up for 3-24 months(median 4.5 months).All fractures healed with a median of 4.5 weeks(range,4-6 weeks).At 3 months,shoulder function was evaluated according to neer function score system.The excellent and good rate was 96.15%.There were 2 cases of fracture re displacement in the treatment process,because the displacement degree is not large,no re reduction;no re fracture,osteofascial compartment syndrome,ischemic muscle contracture and nerve,vascular injury and other complications occurred in all patients.Conclusion:fracture reduction and fixation with Chens characteristic paper embracing splint in the treatment of humeral surgical neck fracture in children is good,reliable,conducive to fracture healing and shoulder joint function recovery,and has fewer complications.

关 键 词：内收型 肱骨外科颈骨折 正骨手法 纸抱壳夹板固定 儿童 

分 类 号：R683.41[医药卫生—骨科学]