肘过伸屈曲手法复位经皮穿针治疗伸直型肱骨髁上骨折的效果  

Effect of elbow over-extension and flexion manual reduction and percutaneous pinning in the treatment of extended supracondylar humeral fractures

作　　者：陈群华 陈莉华 殷琴 CHEN Qunhua;CHEN Lihua;YIN Qin(Department of Orthopedics,Longyan Traditional Chinese Medicine Hospital of Xiamen University,Fujian Province,Longyan364000,China)

机构地区：[1]厦门大学附属龙岩中医院骨伤科,福建龙岩364000

出　　处：《中国当代医药》2024年第23期66-70,共5页China Modern Medicine

基　　金：福建省龙岩市科技计划项目(2021LYF17059)。

摘　　要：目的探讨肘过伸屈曲手法复位经皮穿针治疗伸直型肱骨髁上骨折的效果。方法选取2021年6月至2022年6月厦门大学附属龙岩中医院收治的60例伸直型肱骨髁上骨折患儿作为研究对象,按照随机数字表法分为试验组(30例)及对照组(30例),试验组采用肘过伸屈曲手法复位并结合经皮穿针固定技术方法,对照组采用肘过伸屈曲手法复位方法。待全面评估骨折位置和愈合情况后,移除石膏、拔除克氏针的同时指导患儿进行功能锻炼,针眼愈合后,配合(余庆阳主任经验方)外洗2号方熏洗。比较两组患儿骨完整性及连续性恢复时间、肘关节功能恢复的时间、术后随访全程是否有Volkmann挛缩、肘内翻畸形和尺神经受损的并发症发生及治疗后第12月肘关节功能评分(Flynn评分系统)的优良率,评价肘过伸屈曲手法与经皮穿针固定相结合治疗儿童肱骨髁上骨折的临床疗效。结果本研究随访60例患儿,随访时间12个月,试验组肘关节功能恢复时间短于对照组,差异有统计学意义(P<0.05);试验组肘关节功能评分优良率高于对照组,差异有统计学意义(P<0.05);两组的骨完整性及连续性恢复时间比较,差异无统计学意义(P>0.05);两组患儿均无Volkmann挛缩、尺神经受损的并发症发生,对照组患儿发生1例肘内翻畸形。结论肘过伸屈曲手法在儿童肱骨髁上骨折(伸直型)的治疗中能迅速准确地复位骨折,避免反复多次整复,在该手法的基础上采用经皮穿针和石膏固定临床疗效相仿,经皮穿针治疗在骨折稳定性、肘关节功能评分优于石膏组,不稳定性骨折建议直接经皮穿针治疗。Objective To explore the effect of elbow over extension and flexion technique reduction and percutaneous needle penetration in the treatment of extended supracondylar fractures of the humerus.Methods A total of 60 pediatric patients with extended supracondylar fractures of the humerus admitted to Longyan Traditional Chinese Medicine Hospital of Xiamen University from June 2021 to June 2022 were selected as the study objects.According to the random number table method,they were divided into experimental group(30 cases)and control group(30 cases).The control group was treated with elbow flexion and extension manual reduction.After comprehensive evaluation of fracture location and healing,the plaster was removed and Kirschner wire was removed,and the patient was guided to perform functional exercise.After the needle eye healed,the patient was washed with No.2 prescription by Director Yu Qingyang.The two groups were compared in terms of bone integrity and continuity recovery time,elbow function recovery time,Volkmann contracture,cubitus varus deformity and ulnar nerve injury during the whole follow-up,and the excellent and good rate of elbow function score(Flynn scoring system)at 12 months after treatment.To evaluate the clinical efficacy of elbow hyperextension and flexion manipulation combined with percutaneous pin fixation in the treatment of supracondylar humeral fractures in children.Results In this study,a total of 60 pediatric patients were followed up for 12 months.The recovery time of elbow joint function in the experimental group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The excellent and good rate of elbow joint function score in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in bone integrity and continuity recovery time between the two groups(P>0.05).Both groups of pediatric patients had no complications such as Volkmann contracture or ul

关 键 词：肘过伸屈曲 穿针 伸直型 肱骨髁上 

分 类 号：R274.11[医药卫生—中医骨伤科学]