早期与延期手法复位对手术治疗儿童肱骨髁上骨折的疗效比较  

作　　者：倪利承 张楠 赵华国[1] 

机构地区：[1]宁波市第六医院,315040

出　　处：《浙江临床医学》2023年第5期715-717,共3页Zhejiang Clinical Medical Journal

摘　　要：目的比较早期与延期手法复位对手术治疗儿童肱骨髁上骨折的疗效。方法2019年5月至2021年5月收治411例GartlandⅡ型、Ⅲ型肱骨髁上骨折患儿。其中205例行早期手法复位后手术治疗,206例行延期手法复位后手术治疗。比较两组患者手术时间、骨折切开复位内固定手术与骨折闭合复位内固定术的数目、术中C型臂X线机透视次数、术中出血量、住院时间、术后功能恢复及并发症情况。结果两组患儿平均随访时间为8个月;与延期复位组比较,早期复位组能减少骨折切开复位内固定术可能,减少术中出血量及手术时间,缩短时间,加速术后功能恢复,但术中透视次数有所增加,差异有统计学意义(P<0.05)。两组均未出现中、重度肘内翻情况。结论早期手法复位后手术治疗肱骨髁上骨折相比延期手法复位后手术效果更好,可降低骨折切开复位比例;缩短手术时间及住院时间、减少术中出血量。Objective To compare the clinical results of early and delayed manual reduction for the surgical treatment of pediatric supracondylar humeral fractures.Method A total of 411 children with humeral supracondylar fractures from May 2019 to May 2021 were included.Among these,205 were operated after early manual reduction and 206 after delayed manual reduction.The operation time,number of open reduction and closure reduction,intraoperative fluoroscopy times,intraoperative bleeding volume,hospitalization days,postoperative review functional recovery and complications were recorded and compared between the two groups.Results All two groups were followed up with an average time of 8.0 months.Compared with the delayed reduction group,the early reduction group could reduce the possibility of surgical incision,reduce intraoperative bleeding and operation time,shorten the number of hospitalizations,and accelerate postoperative functional recovery,but the number of intraoperative fluoroscopies increased,and the difference was statistically significant(P<0.05).Conclusion Surgical treatment of humeral supracondylar fracture in children after early surgical reduction has better clinical results than the delayed surgical reduction,which can reduce the proportion of open reduction,shorten operation time,lessen intraoperative bleeding,and shorten hospitalization time.

关 键 词：手法复位 肱骨髁上骨折 儿童 手术 

分 类 号：R726.8[医药卫生—儿科]