闭合复位联合内侧小切口经皮穿针固定治疗儿童GartlandⅢ型肱骨髁上骨折的短期疗效及安全性评估  

Short term efficacy and safety evaluation of closed reduction combined with percutaneous needle fixation through a small medial incision for the treatment of GartlandⅢsupracondylar fractures of the humerus in children

作　　者：纵成成 杨峰[1] 张思成 孙军 ZONG Cheng-cheng;YANG Feng;ZHANG Si-cheng(Department of Orthopedics,Suzhou Hospital Affiliated to Anhui Medical University,Suzhou Anhui 234000,China;Department of Orthopedics,Anhui Children's Hospital,Hefei Anhui 230022,China)

机构地区：[1]安徽医科大学附属宿州医院骨科,安徽宿州234000 [2]安徽省儿童医院骨科,安徽合肥230022

出　　处：《临床和实验医学杂志》2024年第16期1735-1738,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省卫生健康科研项目(编号:AHWJ2022b008);2022年度宿州市卫生健康委科研项目(编号:SZWJ2022a036)。

摘　　要：目的探讨闭合复位联合内侧小切口经皮穿针固定治疗儿童GartlandⅢ型肱骨髁上骨折的短期疗效及安全性评估。方法前瞻性选取2019年6月至2023年6月在安徽医科大学附属宿州医院治疗的80例GartlandⅢ型肱骨髁上骨折患儿进行临床研究,按照随机数字表法将其分为观察组和对照组,各40例。观察组患儿采用闭合复位联合内侧小切口经皮穿针内固定治疗,对照组患儿采用闭合复位经皮穿针固定治疗。比较两组患儿的手术过程指标(手术时间、出血量、住院时间)、骨折愈合时间,术后1、3、7 d的疼痛程度[视觉模拟评分法(VAS)评分]、肘关节活动能力、肘关节功能差异,并对比并发症发生情况。结果观察组的手术时间、住院时间分别为(66.9±8.1)min、(6.8±1.8)d,均长于对照组[(53.0±6.7)min、(5.5±1.5)d],出血量为(48.0±5.6)mL,大于对照组[(17.4±5.1)mL],差异均有统计学意义(P<0.05);两组患儿术后骨折愈合时间比较,差异无统计学意义(P>0.05)。两组术前、术后7 d的的VAS评分比较,差异均无统计学意义(P>0.05);观察组患儿术后1、3 d的VAS评分分别为(2.74±0.69)、(1.43±0.52)分,均高于对照组[(2.21±0.53)、(1.31±0.48)分],差异均有统计学意义(P<0.05)。术后4~6周,观察组患儿的肘关节屈曲、伸直功能分别为(129.6±7.0)、(6.7±1.7)°,均小于对照组[(134.9±6.1)、(8.4±1.8)°],差异均有统计学意义(P<0.05);观察组患儿的肘关节旋前、旋后功能与对照组比较,差异均无统计学意义(P>0.05)。观察组患儿的肘关节疼痛程度评分、肘关节运动功能评分、肘关节活动稳定性评分、日常活动情况评分、Mayo总分与对照组比较,差异均无统计学意义(P>0.05)。观察组患儿的手术并发症率为2.50%,低于对照组(20.00%),差异有统计学意义(P<0.05)。结论闭合复位联合内侧小切口经皮固定与闭合复位经皮穿针固定治疗儿童GartlandⅢ型肱骨髁上骨折均具有�Objective To explore the short-term efficacy and safety evaluation of closed reduction combined with percutaneous needle fixation through a small medial incision for the treatment of GartlandⅢsupracondylar fractures of the humerus in children.Methods A total of 80 children with Gartland typeⅢsupracondylar fracture of humerus treated in Suzhou Hospital Affiliated to Anhui Medical University from June 2019 to June 2023 were prospectively selected for clinical study.They were divided into the observation group and the control group according to the random number table method,with 40 cases in each group.The observation group received closed reduction combined with percutaneous needle fixation through a small inner incision,while the control group received closed reduction percutaneous needle fixation.The surgical process indicators(operation time,blood less,length of hospital stay),fracture healing time,pain scores[visual analogue scale(VAS)scores]at 1,3,7 d after operation,elbow joint activity ability,elbow joint function,and occurrence of complications were compared between the two groups.Results The operation time and hospitalization time of the observation group were(66.9±8.1)min and(6.8±1.8)d,respectively,which were longer than those of the control group[(53.0±6.7)min and(5.5±1.5)d],the amount of bleeding was(48.0±5.6)mL,which was greater than that of the control group[(17.4±5.1)mL],and the differences were statistically significant(P<0.05).There were no significant differences in VAS scores between the two groups before and 7 days after operation(P>0.05);the VAS scores of the observation group at 1 and 3 days after operation were(2.74±0.69)and(1.43±0.52)points,respectively,which were higher than those of the control group[(2.21±0.53)and(1.31±0.48)points],and the differences were statistically significant(P<0.05).At 4-6 weeks after operation,the elbow flexion and extension functions of the observation group were(129.6±7.0)°and(6.7±1.7)°,respectively,which were lower than those of the control gr

关 键 词：闭合复位 经皮穿针固定 小切口 内固定 GARTLAND Ⅲ型 肱骨髁上骨折 儿童 疗效 安全性 

分 类 号：R726.8[医药卫生—儿科]