手法复位克氏针固定治疗儿童肱骨髁上骨折的疗效分析.docVIP

精品论文 参考文献 手法复位克氏针固定治疗儿童肱骨髁上骨折的疗效分析 郝世祥1 贺俭2 　　（1德阳市骨科医院骨科 四川 德阳 618000；2德阳市人民医院 四川 德阳 618000） 　　【摘要】 目的：评价手法复位克氏针固定治疗儿童肱骨髁上骨折的疗效。方法：回顾性分析2010年1月至2015年3月采用手法复位结合经皮克氏针内固定方法治疗的60例肱骨髁上骨折患儿的疗效，所有病例都随访24月。结果：在24月内，所有患者均为骨性愈合，未出现骨折延迟愈合、不愈合及骨化性肌炎、前臂骨筋膜综合征、医源性神经损伤及Volkmann肌挛缩。术后出现尺神经损伤表现的有3例，症状在术后的6个月内完全消失。依据HSS肘关节疗效评定标准，优50例，良7例，一般3例，差0例。结论：对于儿童肱骨髁上骨折，为了减轻手术对患儿骨膜和骨骺造成的损伤，用手法复位满意后用克氏针固定的方法治疗能够获得较好的疗效。 　　【关键词】 手法复位克氏针；儿童肱骨髁上骨折；疗效 　　【中图分类号】R245 【文献标识码】A 【文章编号】2095-1752（2015）19-0360-02 　　Analysis on Curative Effect of Children Humeral Supracondylar Fracture by Manipulative Reduction Kirschner Wire 　　Hao Shixiang,He Jian 　　【Abstract】Objective To evaluate the curative effect of Children humeral supracondylar fracture by manipulative reduction kirschner wire.Methods To retrospectively analyze the curative effect of 60 cases of humeral supracondylar fracture by manipulative reduction kirschner wire during January, 2010 to March, 2015, which with 24 months follow-up visit.Results In 24 months, all the cases were bone unions, not bone union delay, disunion ormyositisossificans, forearm anadesma symptom complex, iatrogenic nerve injury and volkmann cramp. 3 cases showed cubital nerve injury which were cleared away in 6 months after surgery. According to HSS ArticulationCubiti Evaluation, there were 50 cases in top class, 7 cases in good class, 3 cases up to grade, while 0 case was poor. Conclusion For children humeral supracondylar fracture, to reduce the injury of periosteum and osteoepiphysisby surgery, the good curative effect can be gotten by manipulative reduction and fixationby kirscher wire. 　　【Key words】Manipulative Reduction Kirschner Wire;Children Humeral Supracondylar Fracture;Curative Effect 　　肱骨髁上骨折常见于10 岁以下儿童，主要是伸展型肱骨髁上骨折，屈曲型肱骨髁上骨折相对较少。肘内翻畸形和Volkman缺血性肌挛缩是肱骨髁上骨折的常见并发症[1]。骨牵引支架疗法、皮牵引法、单纯手法整复法、切开复位内固定法和手法闭合复位穿针固定法是治疗肱骨髁上骨折的主要方法[2]，前三种方法由于固定不太稳定，可能发生再错位，而切开复位内固定法可能损伤患儿骨膜和骨骺，因此手法闭合复位穿针固定法既可稳定骨折又可减少对患儿骨膜和骨骺的损伤。我们回顾性分析了201