不同手术方法治疗肱骨髁上骨折疗效对比分析.docVIP

不同手术方法治疗肱骨髁上骨折的疗效对比分析 　　[摘要] 目的 探讨不同手术方法治疗肱骨髁上骨折的疗效。 方法 选取80例肱骨髁上骨折患者，随机分组，观察组采取关节外侧小切口术式治疗，对照组行肱三头肌舌形瓣入路术式治疗，比较两组治疗效果及不良反应发生率。 结果 观察组关节功能恢复时间、手术时间、切口长度、术中出血量以及骨折愈合时间均优于对照组，差异有统计学意义（P0.05）； 观察组Johner-Wruh评分优良率高达92.5%，优于对照组优良率77.5%，差异有统计学意义（P0.05）；经随访，观察组4例（10%）不良反应，对照组11例（27.5%），差异有统计学意义（P0.05）。 结论 肱骨髁上骨折应用关节外侧小切口术式进行治疗效果显著，值得临床推广。 　　[关键词] 肱三头肌舌形瓣入路；关节外侧小切口；肱骨髁上骨折 　　[中图分类号] R685 [文献标识码] A [文章编号] 1674-0742（2014）06（b）-0012-02 　　[Abstract] Objective To observe the clinical effect of different surgical methods in the treatment of humeral supracondylar fractures. Methods 80 cases of humeral supracondylar fracture patients were chosen and randomly divided into the observation group treated by small lateral incision surgery treatment， the control group treated by the triceps tongue shaped flap approach surgical treatment. And the treatment effect and incidence of adverse reactions of two groups were compared. Results The joint function recovery time， operation time， length of incision， intraoperative blood loss and the healing time of fracture of the observation group were better than those of the control group， the differences were statistically significant（P0.05）； the excellent and good rate of Johner-Wruh score of patients in the observation group reached 92.5%， higher than 77.5% of the control group， the difference was statistically significant（P0.05）； the follow-up showed that the observation group had 4 cases （10%） of adverse reactions， while the control group had 11case（27.5%）， the difference was statistically significant（P0.05）. Conclusion The curative effect of small lateral incision operation in the treatment of humeral supracondylar fractures is better， which is worthy of clinical promotion. 　　[Key words] The triceps tongue shaped flap approach； Small lateral incision； Humeral supracondylar fractures 　　肱骨髁上骨折[1]因解剖结构特殊，若骨折断端复位不佳，固定不稳，多形成畸形愈合，处理不当还可引起Volkman缺血性肌肉挛缩、肘内翻等并发症，一旦发生，后果严重，影响患者功能、美观。随着相关研究的深入，不同的手术入路、方式也逐步应用于临床。目前临床上较为普遍的是采用关节外侧小切口入路和肱三头肌舌形瓣两种入路，