儿童肱骨远端全骺分离疗效相关因素研究.doc

儿童肱骨远端全骺分离疗效相关因素研究[摘要] 目的 观察影响儿童肱骨远端全骺分离疗效的相关因素。方法 回顾性分析我院2000～2008年收治的50例肱骨远端全骺分离患儿的临床资料,据李稔生等疗效评定标准评定治疗效果。结果 手法复位石膏外固定组12例,优良率66.7%,肘内翻发生率42%,肘内翻最大达20°;闭合复位克氏针固定组10例,优良率90%,肘内翻发生率30%,其中1例肘内翻达12°;切开复位手术组28例,优良率为96.4%,肘内翻发生率11%,肘内翻最大仅10°。结论 切开复位克氏针固定治疗儿童肱骨远端全骺分离,可达解剖复位,降低肘内翻发生几率,最大程度地恢复患肢功能。 [关键词] 肱骨远端全骺分离;疗效;儿童 [中图分类号] R68[文献标识码] A [文章编号] 1673-9701(2010)06-116-03 Curative Efficacy of Child Distal Humeral Epiphysiolysis and Its Related Factors WU Cong The Second Affiliated Hospital of Northern Sichuan Medical College,Mianyang 621000,China [Abstract] Objective To observe the curative efficacy of child distal humeral epiphysiolysis and its relevant factors. Methods A retrospective analysis was made of the data of 50 cases of child distal humeral epiphysiolysis in our hospital from 2000 to 2008,and the assessment of its curative efficacy was made by using Li Rensheng et al?s standards. Results In 12 cases of the manual reduction and plaster external fixation,the excellent rate was 66.7% and the elbow varus incidence was 42%,with the elbow varus maximum reaching 20°. In 10 cases of the closed reduction and Kirschner wire fixation,the excellent rate was 90% and the elbow varus incidence was 30%,with the elbow varus reaching 12°. In 28 cases of the open reduction and surgery,the excellent rate was 96.4% and the incidence of elbow varus was 11%,with the elbow varus maximum reaching only 10°.Conclusion The open reduction and Kirschner wire fixation for child distal humeral epiphysiolysis can reach the anatomic reduction,decrease the elbow varus occurrence,and maximize the recovery of the function of the involved limb. [Key words] Distal humeral epiphysiolysis;Curative efficacy;Children 儿童肱骨远端骨骺分离是发生在幼儿发育阶段的一种特殊类型髁上骨折,多发生于3岁以下儿童,居儿童肱骨远端骨折首位(67.71%)[1],由于幼儿肘部骨骼多未骨化,误诊率极高。治疗不当可继发肘内外翻畸形和肘关节屈伸功能障碍。本院自2000年7月～2008年5月共收治50例肱骨远端骨骺分离患儿,现报道如下。 1资料与方法 1.1临床资料 50例中,男38例,女12例;年龄6个月～9岁,平均5岁;摔伤45例,交通伤3例,高处坠落伤2例。按Salter-Harris分型,Ⅰ型12例,Ⅱ型38例。 1.2治疗方法 1