中西医结合治疗儿童前臂双骨折  

Treatement for fractures of the ulna and radius in children with TCM and WM

作　　者：刘同行[1] 郭德权[1] 徐晓峰[2] 羊国民[1] 徐国平[1] 孔德宏[1] 

机构地区：[1]镇江市第四人民医院,江苏镇江212001 [2]江苏大学附属医院

出　　处：《中国骨伤》2003年第5期260-261,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨儿童前臂双骨折治疗中 ,应该采用适宜的治疗方法来提高治疗的功能效果。方法　对 95例 7～ 1 4岁闭合性、移位的前臂双骨折 ,其中 74例按不同的骨折类型早期手法复位 ,夹板或石膏外固定 ,重点注意克服存在的旋转因素 ,不成功者给予手术治疗。适宜的指导功能锻炼。另有2 1例进行开放复位 ,钢板螺丝钉内固定 ,以后二次手术 ,取内固定。结果　 74例中 67例手法复位成功 ,成功率为 90 5 % ,骨折愈合时间为 32～ 45d ,平均 41d。 7例手法复位不成功采用手术治疗 ,其中 2例为小切口撬拨治疗。骨折愈合时间为 85～ 95d,平均 91d。手法复位组中 <6h就诊 60例中 3例不成功 ,>6h就诊 1 4例中 4例不成功。经随访 1年以上 ,2例有 1 0°左右的旋转。 2 1例手术骨折愈合时间为 75～ 1 50d ,平均 92d。皆于 6个月～ 1年取钢板。结论　儿童前臂双骨折应尽早应用手法复位是重要的 ,旋转移位是前臂双骨折复位成功和功能恢复好的关键性因素 ,应主动加以克服 ,复位成功率是可以提高的 ,开放复位对儿童前臂双骨折不能作为首选 ,应进一步理解中西医结合治疗骨折的观念 ,融入有限的手术 ,便于护理 。Objective To investigate the suitable method for improving good function in the treatment of childrens fracture of the ulna and radius.Methods 95 cases(age from 7 to 14 years old) of closed and displaced fracture of the ulna and radius were studied.74 of them were treated with manual reduction and splint or plaster external fixation.The rotation of the fracture ends should be noticed and overcome.The surgical treatment was for unsuccessful cases.21 of them were treated with open reduction and internal fixation.The plate and screws were removed with secondary operation.Results 67 cases with manual reduction were successful and the successful rate was 90 5%.Fracture healing time was from 32 to 45 days with average 41 days.7 cases with unsuccessful manual reduction were treated by surgery.In 2 cases of them the fractures were prized under small incision.In the patients with the manual reduction,3 cases were unsuccessful in 60 cases who were treated within 6 hours,4 cases were unsuccessful in the 16 cases beyond 6 hours.With more than one year followed up,2 cases of them showed about 10° rotation.Fracture healing time of 21 cases was from 75 to 150 days with average 92 days.The plates were removed after half a year or a year.Conclusion The early manual reduction was important for childrens fracture of the ulna and radius.Controlling the rotation of the fracture ends is the key factor for success.Open reduction is not the first choice for the childrens fracture of the ulna and radius.The concept of combined treatment of traditional Chinese and western medicine should be understood to improve cure rate.

关 键 词：中西医结合治疗 儿童 前臂双骨折 手术治疗 内固定 功能锻炼 

分 类 号：R726.834.1[医药卫生—儿科]