儿童肱骨髁上骨折治疗后肘关节功能康复锻炼方法及疗效评价  

Exercise method and effect evaluation of elbow joint function rehabilitation after treatment of humeral supracondylar fracture in children

作　　者：张新萍 赵瑞芳 陈丽[2] 高艳 王辰轩 程富礼[2] ZHANG Xin-ping;ZHAO Rui-fang;CHEN Li;GAO Yan;WANG Chen-xuan;CHENG Fu-li(Department of General Practice,Henan Provincial Peoples Hospital,Peoples Hospital of Zhengzhou University,Zhengzhou 450003,China;Department Ⅰ of Pediatric Orthopaedics,Zhengzhou Orthopaedic Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院,郑州大学人民医院全科医学科,郑州450003 [2]郑州市骨科医院小儿骨科Ⅰ,郑州450000

出　　处：《医药论坛杂志》2023年第13期16-18,22,共4页Journal of Medical Forum

摘　　要：目的 探讨采用肘关节功能锻炼结合中药熏洗,对儿童肱骨髁上骨折复位后肘关节进行功能锻炼,评估其效果并分析肘关节活动障碍的影响因素。方法 回顾性分析2019年1月至2019年6月河南省人民医院收治的76例肱骨髁上骨折患儿,根据治疗方法不同分为:保守治疗组(手法复位夹板或石膏固定)39例,手术治疗组(手法复位经皮克氏针固定)37例,复位后采用标准化肘关节功能锻炼方法,并结合我院配制的中药洗药熏洗,评估肱骨髁上骨折治疗后患儿的肘关节伸屈活动情况。结果 76例患儿均达到平均1年的临床观察随访,在末次随访时,97%的患者患肢肘关节相对运动范围达到80%,88%的患者患肢肘关节相对运动范围达到90%,68%的患肢肘关节相对运动范围达到了100%。与健侧肘关节相比,患侧肘关节平均屈曲度、平均伸直度、平均绝对运动范围均无统计学意义(P>0.05)。按照Flynn等级评分量表:结果优为61例,良为12例,可为3例,优良率为96%。随访过程中没有出现因康复锻炼骨折再移位或骨折延迟愈合、不愈合病例。结论 儿童肱骨髁上骨折经复位治疗后,按照标准化肘关节锻炼方法,并结合我院配制的中药熏洗,能达到良好的康复结果。Objective To explore the use of elbow joint functional exercise combined with traditional Chinese medicine fumigation and washing to perform functional exercise on the elbow joint after reduction of supracondylar fractures of the humerus in children,evaluate the effect and analyze the influencing factors of elbow joint movement disorders.Methods A retrospective analysis of 76 children with supracondylar fractures of the humerus admitted from January 2019 to June 2019 and they were divided into conservative treatment group(manual reduction splint or plaster fixation),39 cases,surgical treatment group(manual reduction and percutaneous Kirschner wire fixation)in 37 cases.After reduction,standardized elbow joint function exercise methods were used,combined with the Chinese medicine lotion prepared by our hospital,to evaluate the elbow joint extension and flexion activities of the children after the treatment of supracondylar fractures of the humerus.Results The 76 children all reached an average 1-year clinical observation follow-up.At the last follow-up,97%of the patients reached 80%of the relative motion range of the elbow joint of the affected limb,and 88%of the patients reached 90%of the relative motion range of the elbow joint of the affected limb.In 68%of the affected limbs,the relative motion range of the elbow joint reached 100%.Compared with the healthy elbow,the average flexion,average extension,and average absolute range of motion of the affected elbow were not statistically significant(P>0.05).According to the Flynn rating scale,61 cases were excellent,12 cases were good,3 cases were possible,and the excellent and good rate was 96%.During the follow-up,there were no cases of fracture displacement or delayed union or nonunion due to rehabilitation exercise.Conclusion After reduction and treatment of supracondylar fractures of the humerus in children,according to the standardized elbow joint exercise method,combined with the traditional Chinese medicine fumigation and washing prepared by our hospital,good r

关 键 词：肱骨髁上骨折 儿童 康复锻炼 

分 类 号：R274.11[医药卫生—中医骨伤科学]