两种术式对肱骨髁上骨折儿童患肢肘关节功能恢复情况及关节活动度的影响比较  

Comparison on the Effects of Two Surgical Methods on Recovery of Elbow Function and Range of Motion in Children with Supracondylar Fracture of Humerus

作　　者：司珂 辛函珂 赵忆雯 SI Ke;XIN Hanke;ZHAO Yiwen(Pediatric Orthopedics,Zhengzhou Orthopedics Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市骨科医院小儿骨科,河南郑州450000

出　　处：《河南医学研究》2025年第7期1271-1274,共4页Henan Medical Research

摘　　要：目的比较两种术式对肱骨髁上骨折儿童患肢肘关节功能恢复情况及关节活动度的影响。方法回顾性分析2020年5月至2022年11月在郑州市骨科医院治疗的75例肱骨髁上骨折儿童临床资料,其中39例行切开复位内固定术,作为切开组;另36例行闭合复位内固定术,作为闭合组。比较两组手术指标(手术时间、术中出血量、透视次数和住院时间)、术后恢复情况(疼痛、患肢肘关节功能恢复情况及关节活动度、骨折愈合时间、并发症)。结果切开组手术时间和住院时间长于闭合组,术中出血量多于闭合组,但透视次数少于闭合组(P<0.05)。入院时和术后第1、3天,两组Wong-Baker疼痛评分比较,差异无统计学意义(P>0.05)。术后1个月时,切开组Mayo肘关节功能评分及活动度低于闭合组(P<0.05);但术后3、6个月时,两组Mayo肘关节功能评分及活动度比较,差异无统计学意义(P>0.05)。两组骨折愈合时间和并发症发生率比较,差异无统计学意义(P>0.05)。结论对于肱骨髁上骨折,切开复位内固定术或闭合复位内固定术均可改善患儿肘关节功能及活动度,但两种术式各有优劣,需结合具体情况制定手术方案。Objective To compare the effects of two surgical methods on recovery of elbow function and range of motion in children with supracondylar fracture of humerus.Methods A retrospective analysis was performed on the clinical data of 75 children with supracondylar fracture of humerus in Zhengzhou Orthopedics Hospital from May 2020 to November 2022,including 39 cases in open group(open reduction and internal fixation)and 36 cases in closed group(closed reduction and internal fixation).The surgical indexes(operation time,intraoperative blood loss,fluoroscopy frequency,hospitalization time)and postoperative recovery(pain,recovery of elbow function,range of motion,fracture healing time,complications)in two groups were compared.Results The operation time and hospital stay in the open group were longer than those in the closed group,and the intraoperative blood loss was more than that in the closed group,but the number of fluoroscopy was less than that in the closed group(P<0.05).At admission and 1 d and 3 d after surgery,there was no significant difference in scores of Wong-Baker pain between the two groups(P>0.05).At 1 month after surgery,scores of Mayo elbow function and range of motion in open group were lower than those in closed group(P<0.05),but there was no significant difference between the two groups at 3 and 6 months after surgery(P>0.05).There was no significant difference in fracture healing time or incidence of complications between the two groups(P>0.05).Conclusion Both open reduction and internal fixation or closed reduction and internal fixation can improve elbow function and range of motion in children with supracondylar fracture of humerus.However,the two methods have their own advantages and disadvantages,so it is necessary to formulate surgical plans according to the specific situation.

关 键 词：肱骨髁上骨折 闭合复位内固定术 切开复位内固定术 肘关节功能 关节活动度 

分 类 号：R683[医药卫生—骨科学]