| 儿童肱骨髁上骨折治疗中预防肘内翻的探讨 |
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Received:April 19, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 魏世隽 |
WEI Shi-jun |
广州军区武汉总医院,湖北,武汉430070 |
Wuhan General Hospital of Guangzhou Military Area,Wuhan 430070,Hubei,China |
wzm998@ 163. com |
| 陈庄洪 |
CHEN Zhuang-hong |
广州军区武汉总医院,湖北,武汉430070 |
Wuhan General Hospital of Guangzhou Military Area,Wuhan 430070,Hubei,China |
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| 韩芳 |
HAN Fang |
广州军区武汉总医院,湖北,武汉430070 |
Wuhan General Hospital of Guangzhou Military Area,Wuhan 430070,Hubei,China |
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| 熊昌源 |
XIONG Chang-yuan |
湖北省中医院骨科 |
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| 蔡贤华 |
CAI Xian-hua |
广州军区武汉总医院,湖北,武汉430070 |
Wuhan General Hospital of Guangzhou Military Area,Wuhan 430070,Hubei,China |
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| 李姣 |
LI Jiao |
湖北省中医院骨科 |
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| 期刊信息：《中国骨伤》2006年19卷，第1期，第6-8页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨儿童肱骨髁上骨折治疗中降低肘内翻的发生率。
方法:回顾性总结76例肱骨髁上骨折病例资料,按治疗方法分为手法复位加小夹板固定组（A组）31例,手法复位加石膏外固定组（B组）24例,尺骨鹰嘴牵引组（C组,2周后去除牵引改石膏固定）9例,手术治疗组（D组）12例。对A组与B组以及4组中的Ⅲa型骨折病例的疗效进行分析比较,并作统计学处理,着重对肘内翻的预防加以探讨。
结果:所有病例经4~36个月随访,通过摄患侧肘关节标准正侧位X线片,治疗前后测量鲍曼氏角（BA角）、携带角（CA角）,参照郭仲华等对肱骨髁上骨折疗效标准的评定。A组与B组的疗效比较（χ2=0.132,P=0.716>0.05）,无显著性差异;C、D组与A、B组中的Ⅲa型骨折治疗结果比较（χ2=6.078,P=0.014<0.05）,有显著性差异。
结论:对于肘内翻的预防应贯穿于骨折复位、固定、复查的全过程。根据骨折类型合理选择治疗方法,正确的复位方法,合理的复位判断及固定方式,手术入路的合理选择无论对保证肘关节的功能还是降低肘内翻的发生率均是关键。 |
| [关键词]:肱骨髁上骨折 肘内翻 手法复位 牵引 外固定 |
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| Treatment of supracondylar fracture of humerus in children:How to reduce the incidence of cubitus varus |
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Abstract:
Objective:To discuss effective therapy for supracondylar fracture of humerus in children and how to reduce the incidence of cubitus varus.
Methods:76 patients of supracondylar fractures of humerus in children were collected and their therapeutic effect were analyzed.They were respectively treated with nonoperative therapy（64 cases） and operative therapy（12 cases,group D）.In nonoperative therapy group:31 cases were treated with manipulative reduction and splinting（group A）,24 cases with manipulative reduction and fixation of the plaster（group B）,9 cases with traction of olecranon of ulnar （group C,fixation with plaster after relieving traction）.The therapeutic effect were compared between group A and group B.The results of type Ⅲa fractures between group C,D and group A,B were analyzed.
Results:All the patients were followed up from 4 to 36 months.The clinical effects were evaluated according to BA,CA angle of measurement in the X-ray and standard of clinical effects.There was no statistical difference between group A and group B（χ2=0.132,P=0.716>0.05）.There was statistical difference for the treatment of type Ⅲa fractures between group C,D and group A,B（χ2=6.078,P=0.014<0.05）.
Conclusion:Preventing the incidence of cubitus varus must penetrate all the course of the treatment.Correct reduction,reasonable fixation and operative approach is a key to ensure function of elbow joint and decrease incidence of cubitus varus. |
| KEYWORDS:Supracondylar fracture of humerus Cubitus varus Manipulative reduction Traction External fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 魏世隽,陈庄洪,韩芳,熊昌源,蔡贤华,李姣.儿童肱骨髁上骨折治疗中预防肘内翻的探讨[J].中国骨伤,2006,19(1):6~8 |
| 英文格式: | WEI Shi-jun,CHEN Zhuang-hong,HAN Fang,XIONG Chang-yuan,CAI Xian-hua,LI Jiao.Treatment of supracondylar fracture of humerus in children:How to reduce the incidence of cubitus varus[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(1):6~8 |
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