旋前复位法与旋后复位法治疗儿童桡骨头半脱位的比较研究  

A comparative study of pronation reduction and supination reduction in the treatment of radial head subluxation in children

作　　者：贾昊若 冯铜铜 杨烨 屈继宁[1] 颉强 Jia Haoruo;Feng Ganggang;Yang Ye(Children's Osteopathy Hospital,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院儿童骨病医院,710054

出　　处：《美中国际创伤杂志》2023年第1期13-15,34,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的:分别对采用前臂旋前和前臂旋后桡骨头挤压屈肘复位法治疗儿童桡骨头半脱位的临床疗效进行分析及安全性比较。方法:2012年8月至2017年12月,采用前臂旋前桡骨头挤压屈肘复位法治疗桡骨头半脱位69例,采用前臂旋后桡骨头挤压屈肘复位法治疗桡骨头半脱位44例,共计113例,男26例,女77例,年龄2~5岁,平均3.5岁,左侧63例,右侧50例。受伤到本次治疗时间0.5~48h。结果:本组113例患者中,旋前复位法治疗69例,成功复位65例,失败4例,旋后复位法治疗44例,成功复位34例,失败10例,统计学检验结果提示旋前组复位成功率明显高于旋后组(P<0.05)。复发患者26例,1w内复发患者18例,1w以上7例,对于复发患者复位后给予绷带屈肘固定,对于其中2例患者反复脱位复位后结合屈肘旋后位支具固定治疗。所有患者均获得6个月随访。采用Mackay标准功能评价系统进行评分,采取前臂旋前复位法和前臂旋后复位法治疗小儿桡骨头半脱位后肘关节屈伸活动和前臂旋转活动均为优。结论:采用前臂旋前复位法、桡骨头挤压屈肘手法复位治疗儿童桡骨头半脱位,复位率高,复位效果好,安全性高,根据研究结果看旋前复位法优于旋后复位法。Objective:To analyze the clinical effect and safety of the radial head subluxation in children treated by pronation of forearm and supination of forearm radial head reduction.Methods:From August 2012 to December 2017,69 cases of radial head subluxation were treated by forearm pronation and 44 cases were treated by forearm supination.There were 113 cases,including 26 males and 77 females,aged from 2 to 5 years,with an average age of 3.5 years,63 cases on the left side and 50 cases on the right side.The time from injury to this treatment was 0.5~48 hours.Results:Among the 113 patients in this group,69 cases were treated by pronation reduction,65 cases were successfully reduced,4 cases failed,44 cases were treated by supination reduction,34 cases were successfully reduced,and 10 cases failed.The statistical test results showed that the reduction success rate of pronation group was significantly higher than that of supination groupp(P<0.05).There were 26 cases of recurrence,18 cases of recurrence within 1 week and 7 cases over 1 week,two of them were treated by repeated reduction and fixation of flexion and supination of elbow.All patients were followed up for 6 months.According to Mackay's standard function evaluation system,the forearm pronation reduction and the forearm pronation reduction were excellent for elbow flexion-extension and forearm rotation after radial head subluxation in children.Conclusion:The treatment of subluxation of radial head in children by pronation reduction of forearm and elbow compression and flexion reduction of radial head has the advantages of high reduction rate,good reduction effect and high safety.According to the research results,the pronation reduction method is superior to the supination reduction method.

关 键 词：桡骨头:半脱位 治疗 

分 类 号：R68[医药卫生—骨科学]