| 肱骨髁上骨折手法复位穿针和夹板固定的疗效比较 |
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Received:May 15, 2006
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| 作者 | Author | 单位 | Unit | E-Mail |
| 潘志雄 |
PAN Zhi-xiong |
佛山市中医院骨科,广东佛山528000 |
Department of Orthopaedics,Foshan Hospital of TCM,Foshan 528000,Guangdong,China |
zhumoshan@21cn.com |
| 朱永展 |
ZHU Yong-zhan |
佛山市中医院骨科,广东佛山528000 |
Department of Orthopaedics,Foshan Hospital of TCM,Foshan 528000,Guangdong,China |
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| 张兆华 |
ZHANG Zhao-hua |
佛山市中医院骨科,广东佛山528000 |
Department of Orthopaedics,Foshan Hospital of TCM,Foshan 528000,Guangdong,China |
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| 陈逊文 |
CHEN Xun-wen |
佛山市中医院骨科,广东佛山528000 |
Department of Orthopaedics,Foshan Hospital of TCM,Foshan 528000,Guangdong,China |
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| 郭跃明 |
GUO Yue-ming |
佛山市中医院骨科,广东佛山528000 |
Department of Orthopaedics,Foshan Hospital of TCM,Foshan 528000,Guangdong,China |
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| 期刊信息：《中国骨伤》2006年19卷，第12期，第719-721页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨肱骨髁上骨折选择手法和手术治疗疗效。
方法:本组240例随机分为2组:夹板组和穿针组。夹板组120例,男85例,女35例,年龄4～7岁,平均5.6岁;GartlandⅡ型65例,Gart-landⅢ型55例;平均就诊时间8.0h;采用手法复位夹板固定治疗。穿针组120例,男80例,女40例;年龄3.6～8.0岁,平均5.4岁;GartlandⅡ型65例,GartlandⅢ型55例;平均就诊时间7.0h;采用手法复位经皮闭合穿针治疗。
结果:240例均得到随访,时间1～6年,平均4年6个月。根据Dodgt疗效标准,夹板组优95例,良13例,差12例,优良率90.0%;穿针组优97例,良13例,差10例,优良率91.6%。GartlandⅡ型夹板组优良率86.2%(56/65),穿针组优良率90.8%(59/65)。GartlandⅢ型夹板组优良率94.5%(52/55),穿针组优良率92.7%(51/55)。夹板组肘内翻3例(GartlandⅡ型2例,GartlandⅢ型1例),发生率2.5%;活动受限14例(GartlandⅡ型10例,GartlandⅢ型4例),发生率11.7%。穿针组肘内翻10例(GartlandⅡ型7例,GartlandⅢ型3例),发生率8.3%;活动受限0例。
结论:手法治疗在防治肘内翻上有优势,手术治疗在保证肘关节活动功能上有优势。对GartlandⅡ型主张采用手法复位经皮穿针固定,GartlandⅢ型则采用手法夹板固定和手术经皮穿针固定治疗疗效无明显差异。 |
| [关键词]:肱骨骨折 骨折固定术 骨科手法 |
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| Comparison between Kirschner fixation and splint fixation after reduction in the treatment of humeral supracondylar fracture |
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Abstract:
Objective:To study therapeutic effects of selective manipulation and operation in the treatment of humeral supracondylar fracture.
Methods:Two hundred and forty patients were divided into splint group(Group A)and Kirschner group(Group B).One hundred and twenty patients in Group A included 85 male and 35 female,ranging in age from 4 to 7 years,with an average of 5.6 years;the average time from injury to treatment was 8.0 h.In Group A 65 patients were Gartland Ⅱtype and 55 patients were Gartland Ⅲ type.All above patients were treated with manipulative reduction and splint fixation.Among 120 patients in Group B,80 patients were male and 40 patients were female,ranging in age from 3.6 to 8.0 years,with an average of 5.4 years;the average time from injury to treatment was 7.0 h.In Group B 65 patients were Gartland Ⅱ type and 55 patients were Gartland Ⅲ type;all the patients in Group B were treated with manipulative reduction and percutaneous Kirschner fixation.The therapeutic effects of the two groups were compared.
Results:All the patients were followed up from 1 to 6 years,with an average of 4 years and 6 months.According to Dodgt evaluation criterion,the results in Group A were excellent in 95 patients,good in 13 and bad in 12,the rate of excellent and good therapeutic results was 90.0%.In Group B 97 patients were excellent,13 good and 10 bad.The rate of excellent and good was 91.6%.The excellent and good rates achieved in the patients with Gartland Ⅱ type fracture in Group A and Group B were 86.2%(56/65)and 90.8%(59/65)respectively,and the rates in those with Gartland Ⅲ type fracture in above two groups were 94.5%(52/55)and 92.7%(51/55)respectively.In Group A,cubitus varus occurred in 3 patients(2 patients were Gartland Ⅱ type and 1 patient was Gartland Ⅲ type)with incidence rate of 2.5%,and limitation of motion occurred in 14 patients(10 patients were Gartland Ⅱ type and 4 patients were Gartland Ⅲ type)with incidence rate of 11.7%.In Group B,the above two complications occurred in 10(7 patients were Gartland Ⅱ type and 3 patients were Gartland Ⅲ type)and 0 patient,and the two incidence rate were 8.3%and zero respectively.
Conclusion:Manipulative treatment has superiority in preventing from cubitus varus,while operative treatment is good in keeping the moving function of elbow joint.For treatment of Gartland Ⅱ fracture,percutaneous Kirschner fixation method should be adopted.There is no significatnt difference between splint fixation and Kirschner fixation in the treatment of Gartland Ⅲ fracture. |
| KEYWORDS:Humeral fractures Fracture fixation Orthopedic manipulation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 潘志雄,朱永展,张兆华,陈逊文,郭跃明.肱骨髁上骨折手法复位穿针和夹板固定的疗效比较[J].中国骨伤,2006,19(12):719~721 |
| 英文格式: | PAN Zhi-xiong,ZHU Yong-zhan,ZHANG Zhao-hua,CHEN Xun-wen,GUO Yue-ming.Comparison between Kirschner fixation and splint fixation after reduction in the treatment of humeral supracondylar fracture[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(12):719~721 |
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