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手法整复经皮穿针治疗儿童GartlandⅢ型肱骨
Hits: 2010   Download times: 1124   Received:February 16, 2014    
作者Author单位UnitE-Mail
陈坤壮 CHEN Kun-zhuang 陆丰市甲子人民医院骨科, 广东 陆丰 516538 Department of Orthopaedics, Jiazi People's Hospital, Lufeng 516538, Guangdong, China chenkunz123@126.com 
蔡立雄 CAI Li-xiong 佛山市中医院骨科, 广东 佛山 528000  
张宏宁 ZHANG Hong-ning 佛山市中医院骨科, 广东 佛山 528000  
郭跃明 GUO You-ming 佛山市中医院骨科, 广东 佛山 528000  
期刊信息:《中国骨伤》2014年27卷,第7期,第583-586页
DOI:10.3969/j.issn.1003-0034.2014.07.012


目的:探讨手法整复经皮闭合穿克氏针内固定治疗儿童Gartland Ⅲ型肱骨髁上骨折的临床疗效。

方法:选择2010年7月至2013年7月儿童Gartland Ⅲ型肱骨髁上骨折患者60例,分为治疗组及对照组。治疗组32例,其中男18例,女14例;年龄5~11岁,平均(7.8±2.7)岁;采用传统“正骨十四法”手法整复经皮闭合穿克氏针固定。对照组28例,其中男16例,女12例;年龄4~12岁,平均(7.2±3.0)岁;采用切开复位克氏针内固定。观察和分析两组在肘关节屈伸活动范围、骨折临床愈合时间和术后6个月Flynm临床功能评定结果。

结果:对照组骨折平均愈合时间(5.01±0.43)周,长于治疗组(4.29±0.29)周(t=7.49,P=0.00).术后6个月治疗组患者肘关节活动范围(146.02±2.28)°,明显大于对照组(140.76±4.42)°(t=-5.67,P=0.00).术后6个月Flynn临床功能评定结果,对照组优7例,良16例,可4例,差1例;治疗组优21例,良9例,可2例(U=3.09,P=0.002).

结论:手法整复闭合穿针法治疗儿童Gartland Ⅲ型肱骨髁上骨折能明显缩短骨折临床愈合时间,临床疗效较好,值得推广。
[关键词]:儿童  肱骨骨折  手法,骨科  病例对照研究
 
Case-control study on the treatment of humerus supracondylar fracture of Gartland Ⅲ in children by manipulative reduction and Kirschner wire percataneous internal fixation
Abstract:

Objective: To study the clinical effect of the Gartland Ⅲ humerus supracondylar fractures in children by manipulative reduction and Kirschner wire percataneous internal fixation.

Methods: From July 2010 and July 2013,60 patients with Gartland Ⅲ humerus supracondylar fracture were selected and divided into treatment group and control group. In the treatment group 32 patients were treated with traditional bone setting tetradeca-manipulative reduction and percataneous Kirschner wire internal fixation,included 18 males and 14 females with an average age of(7.8±2.7) years old ranging from 5 to 11;in the control group 28 patients were treated with open reduction and Kirschner wire internal fixation,included 16 males and 12 females with an average age of (7.2±3.0) years old ranging from 4 to 12. The motion range of the elbow joint,the time of fracture clinical healing,and the effect after 6 months of Flynm clinical functional assessment standards were observed and compared.

Results: The average fracture healing time of the control group(5.01±0.43) weeks was longer than that of the treatment group(4.29±0.29) weeks(t=7.49,P=0.00). At 6 months after treatment,the elbow motion range of the treatment group (146.02±2.28) was more than that of the control group (140.76±4.42) (t=-5.67,P=0.00). At 6 months after treatment,according to Flynn evaluation,in the control group,there were 7 cases as excellent,16 as good,4 fair,1 poor; in the treatment group,excellent in 21,good in 9,fair in 2 (U=3.09,P=0.002).

Conclusion: Manipulative reduction and Kirschner wire percataneous internal fixation for treatment of children's Gartland Ⅲ humerus condyle fractures can shorten fracture clinical healing time and the clinical curative effect is better.
KEYWORDS:Child  Humeral fractures  Manipulation,orthopedic  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:陈坤壮,蔡立雄,张宏宁,郭跃明.手法整复经皮穿针治疗儿童GartlandⅢ型肱骨[J].中国骨伤,2014,27(7):583~586
英文格式:CHEN Kun-zhuang,CAI Li-xiong,ZHANG Hong-ning,GUO You-ming.Case-control study on the treatment of humerus supracondylar fracture of Gartland Ⅲ in children by manipulative reduction and Kirschner wire percataneous internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(7):583~586
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