两种的方法治疗肱骨髁上骨折疗效比较.docVIP

两种的方法治疗肱骨髁上骨折疗效比较 　　【摘要】 目的 探讨肱骨髁上骨折两种治疗方法的临床疗效及适应证。方法 深圳龙岗中心医院从2002~2009年对142例肱骨髁上骨折患者用手法复位经皮克氏针固定治疗65例,用骨折切开复位“Y”形钛板固定治疗77例。按骨折愈合时间、肘内翻、肘关节功能方面进行探讨比较。结果 全部病例随访6～25月,平均18月。肘内翻克氏针组发生率9.2%,“Y”型钛板组发生率3.8%。按jupiter肘关节功能评定标准,克氏针组优良率89.2%,“Y”型钛板组优良率96.1%。骨折愈合时间克氏针组平均12.5周,“Y”型钛板组平均14周。结论 从术后肘关节功能、肘内翻发生率来看,“Y”型钛板内固定优于克氏针内固定,但克氏针组骨折愈合时间较前者短。 　　【关键词】 肱骨髁上骨折; 克氏针;“Y”型钛板 　　 　　Comparison of two therapeutic methods in treatment of C1 fracture of distal humerus 　　YU ying-jian.Department of Orthoaedics,the Longgang District Central Hospital of Shenzhen Guangdong,Shenzhen 518116, China 　　 　　【Abstract】 Objective To evaluate two therapeutic methods in treatment of C1 fractures of distal humerus.Methods From 2002 to 2009, 142 cases of C1 fractures of distal humerus were treated with K-wires(65cases), Y-shape plating (77 cases). The comparison was carrying on according to the fracture healing time,cubitus varus ,functions of the elbow. Results All the cases were followed up. The follow-ups ranged from 6 to 25 months, with an average of 18 months.The cubitus varus rate was 9.2% in K-wires, 3.8% in Y-shape plating.According to the Jupiter scoting sustem, the elbow function was excellent and good in 89.2% of cases in K-wires, 96.1% in Y-shape plating. The fracture healing time was 12.5 weeks in K-wires, 14 weeks in Y-shape plating.Conclusion According to comparison of functions of the elbow and the cubitus varus rate between two groups , Y-shape plating group are more favorable than K-wires. But the fracture healing time of K-wires is short than the former. 　　【Key words】C1 fractures of distal humerus; K-wires;Y-plate 　　 　　肱骨髁上骨折小儿多见,约占四肢骨折3%～7%,占肘部骨折30%～50%,多见于5～12岁。从2002~2009年,对本院肱骨髁上骨折病采用手法复位经皮克氏针内固定及切开复位“Y”型钛板内固定治疗进行比较,报告如下。 　　 　　1 资料与方法 　　1.1 一般资料 经皮克氏针内固定组:本组65例,其中男36例,女29例,年龄6～30岁,平均12岁。跌伤38例,车祸伤16例,击伤11例,为闭合性单纯性髁上骨折。其中伸直型41例,屈曲型24例,左侧27例,右侧38例。受伤至手术时间2 h～1 d,平均6 h。均无合并神经血管损伤; 用“Y”型钛板内固定组:本组77例,其中男40例,女37例,年龄5～41岁,平均13岁。跌伤35例,车祸伤25例,击伤17例。其中伸直型46例,屈曲型31例。有9例合并髁间骨折,6例合