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儿童严重移位肱骨髁上骨折伴神经损伤的治疗策略
Hits: 2149   Download times: 1441   Received:September 11, 2008    
作者Author单位UnitE-Mail
仲肇平 ZHONG Zhao-ping 宁波市第六医院小儿骨科,浙江 宁波 315040 Department of Pediatric Orthopaedics,Ningbo No. 6 Hospital,Ningbo 315040,Zhejiang,China  
曹进 CAO Jin 宁波市第六医院小儿骨科,浙江 宁波 315040 Department of Pediatric Orthopaedics,Ningbo No. 6 Hospital,Ningbo 315040,Zhejiang,China  
任荣 REN Rong 宁波市第六医院小儿骨科,浙江 宁波 315040 Department of Pediatric Orthopaedics,Ningbo No. 6 Hospital,Ningbo 315040,Zhejiang,China  
彭琳瑞 PENG Lin-rui 宁波市第六医院小儿骨科,浙江 宁波 315040 Department of Pediatric Orthopaedics,Ningbo No. 6 Hospital,Ningbo 315040,Zhejiang,China  
陈秋 CHEN Qiu 宁波市第六医院小儿骨科,浙江 宁波 315040 Department of Pediatric Orthopaedics,Ningbo No. 6 Hospital,Ningbo 315040,Zhejiang,China  
期刊信息:《中国骨伤》2009年22卷,第1期,第27-28页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:探讨儿童肱骨髁上骨折伴神经损伤的临床特点及治疗策略。

方法:对2000年6月至2006年12月收治的28例肱骨髁上骨折伴神经损伤的患儿进行总结分析,所有骨折均为Gartland Ⅲ型,其中闭合性损伤24例,开放性损伤4例。16例(A组)行闭合复位穿针固定,12例(B组)行骨折切开复位并神经探查。切开手术者发现8例神经为挫伤,3例为嵌顿伤,1例为断裂伤。

结果:28例神经功能均完全恢复,其中闭合复位穿针者4~6周内恢复13例, 8~10周2例,12周1例;切开手术者神经功能恢复4~6周6例, 8~10周3例,12~16周3例。

结论:儿童肱骨髁上骨折伴神经损伤者,大部分损伤的神经功能可以在骨折闭合复位后逐步恢复,但必要时切开复位、神经探查、修复,同样有重要的现实意义。
[关键词]:肱骨髁上骨折  神经损伤  儿童  临床方案
 
The therapeutic strategy of humeral supracondylar fracture with never injury in children
Abstract:

Objective: To determine the clinical features and therapeutic strategy of humeral supracondylar fractures with nerve injuries in children.

Methods: From June 2000 to December 2006,28 patients of humeral supracondylar fracture(Gartlang Ⅲ)with never injuries were analyzed. Twenty-four patients were close injuries and the others were open. Sixteen cases(group A)were treated with close reduction and K-wires fixation. Twelve cases(group B)were treated with open reduction and nerve exploration,among them,contusive nerve injuries in 8 cases,incarceration in 3,complete neurotmesis in 1.

Results: The symptoms of nerve injuries of 28 cases recovered completely within 4 to 6 weeks in 13 cases,8 to 10 weeks in 2 cases and 12 weeks in 1 case in group A,meanwhile,within 4 to 6 weeks in 6 cases,8 to 10 weeks in 3 cases and 12 to 16 weeks in 3 cases in group B.

Conclusion: Most nerve injuries in humeral supracondylar fractures in children can be cured after close reduction of the fracture. Sometimes,open reduction and nerve exploration are necessary,which has important practical significance.
KEYWORDS:Humeral supracondylar fractures  Nerve injury  Children  Clinical protocols
 
引用本文,请按以下格式著录参考文献:
中文格式:仲肇平,曹进,任荣,彭琳瑞,陈秋.儿童严重移位肱骨髁上骨折伴神经损伤的治疗策略[J].中国骨伤,2009,22(1):27~28
英文格式:ZHONG Zhao-ping,CAO Jin,REN Rong,PENG Lin-rui,CHEN Qiu.The therapeutic strategy of humeral supracondylar fracture with never injury in children[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(1):27~28
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