[1]梁勇 江平频 张新武 郭剑波△.屈肘位牵引摇摆复位手法结合克氏针内固定治疗儿童肱骨髁上骨折32例[J].中国中医骨伤科杂志,2021,29(05):62-65.
　LIANG Yong JIANG Pingpin ZHANG Xinwu GUO Jianbo.32 Cases Clinical Report of Supracondylar Fracture of Humerusin Children Treated by Elbow Flexion and Swing ReductionTechnique Combined with Kirschner Wire Internal Fixation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(05):62-65.
点击复制

屈肘位牵引摇摆复位手法结合克氏针内固定治疗儿童肱骨髁上骨折32例()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年05期
页码:
62-65
栏目:
临床报道
出版日期:
2021-05-15

文章信息/Info

Title:
32 Cases Clinical Report of Supracondylar Fracture of Humerusin Children Treated by Elbow Flexion and Swing ReductionTechnique Combined with Kirschner Wire Internal Fixation
文章编号:
1005-0205(2021)05-0062-04
作者:
梁勇1 江平频1 张新武1 郭剑波1△
1新余市中医院(江西 新余,338025)
Author(s):
LIANG Yong1 JIANG Pingpin1 ZHANG Xinwu1 GUO Jianbo1△
1Xinyu Traditional Chinese Medicine Hospital,Xinyu 338025,Jiangxi China.
关键词:
肱骨髁上骨折;  正骨手法;  儿童
Keywords:
supracondylar fracture of humerus;  fracture reduction technique;  children
分类号:
R683.41
文献标志码:
B
摘要:
目的:探讨Gartland Ⅲ型儿童肱骨髁上骨折屈肘位牵引摇摆复位手法的临床疗效。方法:2014年12月至2019年12月,本科采用屈肘位牵引摇摆复位手法复位、闭合穿针内固定治疗32例Gartland Ⅲ型儿童肱骨髁上骨折患者,疗效评定采用Flynn肘关节临床功能评分标准,随访观察治疗效果及不良反应。结果:本组手法复位时间(5±3)min。1次复位成功27例,2次复位成功5例,其中解剖复位28例,功能复位4例。术中透视(13±5)次,中位数9次。平均住院5 d(3～12 d),32例患者均获随访,最短6个月,最长18个月,中位数12个月。骨折均在术后3～5周获得临床愈合,拆除外固定和克氏针,指导循序渐进进行肘关节的主被动功能锻炼。疗效评定采用Flynn肘关节临床功能评分标准:术后3个月统计患肘关节总优良率为90.6%(29/32),术后6个月统计患肘关节总优良率为100%(32/32)。本组患者术后未出现医源性血管损伤、骨筋膜室综合征等严重不良并发症,未发生肘内翻。5例术前合并有神经、血管损伤患者均在3个月内得到良好恢复。结论:Gartland Ⅲ型儿童肱骨髁上骨折屈肘位牵引摇摆复位手法,符合逆损伤机制复位原理,一次复位成功率较高,复位效果好,综合疗效好,安全性高,且施术者较省力,值得临床推广应用。
Abstract:
To explore the clinical efficacy of Gartland type Ⅲ humeral supracondylar fracture in children treated by elbow flexion traction and swing reduction.Methods:Elbow flexion traction and swing reduction and closed pin internal fixation were used to treat 32 children with Gartland type Ⅲ humeral supracondylar fractures.The curative efficacy was evaluated by flynn elbow joint clinical function score standards.Efficacy of treatment and adverse reactions were recorded in the follow-up.Results:This group of manual reduction time was(5±3)min.27 cases were successfully restored at one time,and 5 cases were successfully restored at the second time,including 28 cases of anatomical reduction and 4 cases of functional reduction.Intraoperative fluoroscopy was performed(13±5)times,with a median of 9 times.The average hospital stay was 5 days(3 to 12 d).All 32 children were followed up 12 months(6 to 18 months).All fractures healed clinically 3 to 5 weeks after the operation.The external fixation and Kirschner wire were removed,and the active and passive functional exercises of the elbow joint were guided step by step for patients.The curative efficacy was evaluated by the flynn elbow joint clinical function scoring standard.The total excellent and good rate of the elbow joint was 90.6%(29/32)after 3 months,and the total excellent and good rate of the elbow joint was 100%(32/32)after 6 months.None of the children in this group had serious adverse complications such as iatrogenic vascular injury and compartment syndrome,and no elbow varus occurred.The 5 children with nerve and blood vessel injuries before the operation all recovered well within 3 months.Conclusion:The supracondylar fracture elbow flexion traction swing reduction technique is in line with the principle of inverse injury mechanism reduction to treat Gartland type Ⅲ pediatric humeral.It has a high success rate of one-time reduction,good reduction efficacy,good overall efficacy,high safety,and less effort for the operator,and is worthy of clinical application.

参考文献/References:

[1] 潘少川.实用小儿骨科学[M].北京:人民卫生出版社,2005:444.
[2] GARTLAND J J.Management of supracondylar fractures of the humerus in children[J].Surg Gynecol Obstet,1959,109(2):145-154.
[3] 王浩然,仲肇平,陈秋.GartlandⅢ型儿童肱骨髁上骨折治疗方式探讨[J].中国中医骨伤科杂志,2014,22(6):29-31.
[4] 于淼,孙绍裘,徐无忌,等.经皮穿针治疗GartlandⅢ型小儿肱骨髁上骨折的临床观察[J].中国中医骨伤科杂志,2011,19(4):34-35.
[5] 张锡玮,胡莹,刘井利.单人整复治疗小儿肱骨髁上骨折162例[J].中国中医骨伤科杂志,2012,20(11):46-47.
[6] 李欣,刘宏,肖晟,等.有限切开复位经皮克氏针内固定治疗儿童难复性Gartland Ⅲ型肱骨髁上骨折[J].中国骨伤,2017,30(1):60-63.
[7] FLYNN J C, MATTHEWS J G, BENOIT R L.Blind pinning of displaced supracondylar fractures of the humerus in children:sixteen years’ experience with long-term follow-up[J].J Bone Joint Surg Am,1974,56(2):263-272.
[8] 孙贤杰,张新根,石钢,等.闭合复位克氏针固定治疗小儿肱骨髁上骨折38例[J].中国中医骨伤科杂志,2019,27(4):44-46.
[9] 陈坤壮,蔡立雄,张宏宁,等.手法整复经皮穿针治疗儿童Gartland Ⅲ型肱骨髁上骨折的病例对照研究[J].中国骨伤,2014,27(7):583-586.
[10] 沈朝忠,马伦,郑伟挺,等.闭合复位经皮克氏针多平面交叉内固定治疗Gartland Ⅱ和Ⅲ型儿童肱骨髁上骨折[J].中医正骨,2019,31(1):65-69.
[11] 吴伟平,李旭,史强,等.Gartland Ⅲ型儿童肱骨髁上骨折的微创治疗[J].南方医科大学学报,2014,34(9):1351-1354.

备注/Memo

备注/Memo:
△通信作者 E-mail:sealthought@163.com
更新日期/Last Update: 2021-05-15