术后早期综合康复对儿童青少年肱骨髁上骨折伴尺神经损伤的效果  

Effect of early postoperative comprehensive rehabilitation on children and youth with supracondylar fracture of humerus complicated with ulnar nerve injury

作　　者：罗丽华[1] 王雨生 李剑锋 董继革[1] LUO Lihua;WANG Yusheng;LI Jianfeng;DONG Jige(Department of Rehabilitation,Wangjing Hospital of China Academy of Chinese Medicine Sciences,Beijing 100102,China;Rehabilitation Medicine Department,the Second Rehabilitation Hospital of Beijing,Beijing 100038,China)

机构地区：[1]中国中医科学院望京医院康复治疗部,北京市100102 [2]北京市第二康复医院康复医学科,北京市100038

出　　处：《中国康复理论与实践》2024年第1期105-110,共6页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的观察术后早期综合康复对并发尺神经损伤的肱骨髁上骨折儿童青少年的肘关节功能障碍与尺神经损伤的效果。方法2016年1月至2021年12月在中国中医科学院望京医院治疗的并发尺神经损伤的肱骨髁上骨折术后的儿童青少年49例,随机分为对照组(n=24)和治疗组(n=25)。对照组采用蜡敷治疗和针灸治疗,治疗组采用药物熏蒸、关节松动术及肌电生物反馈治疗,治疗12周。治疗前后分别采用美国特种外科医院肘关节评定表(HSS)和英国医学研究院神经外伤学会报告(MCRR)进行评估。结果治疗后,两组HSS评分均显著升高(|t|>8.345,P<0.001),治疗组HSS评分显著高于对照组(t=4.536,P<0.001),治疗组治疗前后HSS评分差值高于对照组(t=3.717,P<0.05)。治疗组尺神经恢复优良率高于对照组(χ^(2)=5.975,P<0.05)。结论术后早期综合康复可改善并发尺神经损伤的肱骨髁上骨折儿童青少年的肘关节功能,促进尺神经恢复。Objective To observe the therapeutic effect of early postoperative comprehensive rehabilitation on elbow joint dysfunction and ulnar nerve injury in children and adolecents with supracondylar fracture of humerus complicated with ulnar nerve injury.Methods A total of 49 children with supracondylar fracture of humerus complicated with ulnar nerve injury after operation were selected from January,2016 to December,2021 in Wangjing Hospital,which were randomly divided into control group(n=24)and treatment group(n=25).The control group accepted wax therapy and acupuncture,and the treatment group accepted medicine fumigation,joint mobilization and electromyographic biofeedback,for twelve weeks.They were assessed with The Hospital for Special Surgery Elbow score(HSS)and Medical Research Neurotrauma Society Report(MCRR)before and after treatment.Results After treatent,the HSS scores increased in both groups(|t|>8.345,P<0.001).The HSS score was significantly higher in the treatment group than in the control group(t=4.536,P<0.001).The d-value of HSS scores before and after treatment was significantly higher in the treatment group than in the control group(t=3.717,P<0.05).The rate of excellent recovery of ulnar nerve function was significantly higher in the treatment group than in the control group(χ^(2)=5.975,P<0.05).Conclusion Early postoperative comprehensive rehabilitation could romote the recovery of elbow function and ulnar nerve injury in children and youth with supracondylar fracture of humerus complicated with ulnar nerve injury.

关 键 词：儿童 青少年 肱骨髁上骨折 尺神经损伤 肘关节功能障碍 早期综合康复 

分 类 号：R683.41[医药卫生—骨科学]