肘后弧形切口与肘前横切口手术复位内固定治疗儿童肱骨髁上骨折的疗效分析  

Analysis of the effect of surgical reduction and internal fixation for supracondylar fracture of humerus in children with posterior elbow curved incision and anterior elbow transverse incision

作　　者：武玥兴 何其濂 WU Yuexing;HE Qilian(Department of Orthopedics,Xi′an International Medical Center Hospital,Xi′an,Shaanxi 710100,China)

机构地区：[1]西安国际医学中心医院骨科,陕西西安710100

出　　处：《检验医学与临床》2023年第17期2533-2536,2542,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨肘后弧形切口与肘前横切口手术复位内固定治疗儿童肱骨髁上骨折的疗效。方法回顾性分析2019年12月至2020年12月西安国际医学中心医院收治的73例肱骨髁上骨折患儿的临床资料,根据不同手术入路方法分为肘后弧形切口组(33例)和肘前横切口组(40例)。记录两组术中断口显露时间、手术时间、术后骨折愈合时间,及术后6周改良肘关节纽约特种外科医院(HSS)功能评分、临床恢复优良率及随访3个月并发症及后遗畸形发生情况。结果两组骨折愈合时间比较,差异无统计学意义(P>0.05);肘前横切口组断口显露时间、手术时间均短于肘后弧形切口组,差异均有统计学意义(P<0.05)。两组手术后6周改良肘关节HSS功能评分均高于手术前,且肘前横切口组高于肘后弧形切口组,差异均有统计学意义(P<0.05)。肘前横切口组临床恢复优良率(90.0%)高于肘后弧形切口组的69.7%,差异有统计学意义(P<0.05)。随访3个月,肘后弧形切口组出现2例肘内翻畸形。肘前横切口组出现1例肘内翻畸形,两组后遗畸形发生率比较,差异无统计学意义(P>0.05);肘前横切口组并发症发生率(5.0%)低于肘后弧形切口组的21.2%,差异有统计学意义(P<0.05)。结论肘前横切口入路治疗儿童肱骨髁上骨折断口显露时间及手术时间均短于肘后弧形切口入路,可有效提高肘关节功能,且并发症少,具有较好的临床疗效。Objective To investigate the effect of surgical reduction and internal fixation for supracondylar fracture of humerus in children with posterior elbow curved incision and anterior elbow transverse incision.Methods The clinical data of 73 children with supracondylar humeral fractures admitted to Xi′an International Medical Center Hospital from December 2019 to December 2020 were retrospectively analyzed.According to different surgical approaches,the patients were divided into posterior elbow curved incision group(33 cases)and anterior elbow transverse incision group(40 cases).The intraoperative incision exposure time,operation time and postoperative fracture healing time were recorded.The Hospital for Special Surgery(HSS)function score of the modified elbow joint,the excellent and good rate of clinical recovery at 6 weeks after operation and the complications and residual deformity at 3 months of follow-up were recorded.Results There was no significant difference in fracture healing time between the 2 groups(P>0.05).The incision exposure time and operation time of the anterior elbow transverse incision group were shorter than those of the posterior elbow curved incision group,and the difference was statistically significant(P<0.05).The modified elbow joint HSS score at 6 weeks after operation in both groups was higher than that before operation,and the score in the anterior elbow transverse incision group was higher than that in the posterior elbow curved incision group,and the differences were statistically significant(P<0.05).The excellent and good rate of clinical recovery in the anterior elbow transverse incision group(90.0%)was higher than 69.7%in the posterior elbow curved incision group,and the difference was statistically significant(P<0.05).There were 2 cases of cubitus varus deformity in the posterior elbow curved incision group and 1 case of cubitus varus deformity in the anterior elbow transverse incision group,and there was no significant difference in the incidence of sequelae between the 2 groups(

关 键 词：肱骨髁上骨折 内固定复位手术 肘关节功能 

分 类 号：R726.8[医药卫生—儿科]