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《肘內(nèi)側(cè)小切口切開復(fù)位與閉合復(fù)位治療兒童肱骨髁上骨折的療效比較-論文.pdf》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫。
1、臨床d,JD~b科雜志2014年6月第l3卷第3期JournalofClinicalPediatricSurgery，June2014，Vo1．13，No．3·l9l··論著·肘內(nèi)側(cè)小切口切開復(fù)位與閉合復(fù)位治療兒童肱骨髁上骨折的療效比較孫慶增史迎春【摘要】目的比較經(jīng)肘內(nèi)側(cè)小切口切開復(fù)位與閉合復(fù)位克氏針內(nèi)固定治療兒童Gartlandm型肱骨髁上骨折的療效。方法我們對(duì)2010年7月至2012年12月收治的124例GartlandⅢ型肱骨髁上骨折患兒，分別采用經(jīng)肘內(nèi)側(cè)小切口切開復(fù)位克氏針內(nèi)固定(切開復(fù)位組)和閉合復(fù)位克氏針內(nèi)固定
2、(閉合復(fù)位組)治療，術(shù)后規(guī)范隨訪，比較兩組手術(shù)時(shí)間，術(shù)中透視次數(shù)，骨折骨性愈合時(shí)間，術(shù)后3個(gè)月、6個(gè)月肘關(guān)節(jié)功能評(píng)分以及術(shù)后近、遠(yuǎn)期并發(fā)癥的發(fā)生率。結(jié)果切開復(fù)位組手術(shù)時(shí)間(50．2±6．81)min，較閉合復(fù)位組短[(81．3±18．98)min]，術(shù)中透視次數(shù)(3．4±1．1)次，少于閉合復(fù)位組[(7．0±2．6)次]，差異有統(tǒng)計(jì)學(xué)意義(P<0．05)。切開復(fù)位組及閉合復(fù)位組于平均術(shù)后8周均獲得骨性愈合。按照Flynn肘關(guān)節(jié)評(píng)分標(biāo)準(zhǔn)評(píng)定療效，術(shù)后3個(gè)月、6個(gè)月切開復(fù)位組優(yōu)良率(分別為86．57％，97．01％)與閉合復(fù)位
3、組(78．95％，92．98％)比較，差異均無統(tǒng)計(jì)學(xué)意義(P>0．05)。兩組術(shù)后近、遠(yuǎn)期并發(fā)癥的總發(fā)生率比較，切開復(fù)位組(8．96％)低于閉合復(fù)位組(28．07％)，差異有統(tǒng)計(jì)學(xué)意義(P<0．05)。結(jié)論經(jīng)肘內(nèi)側(cè)小切口切開復(fù)位治療GartlandⅢ型肱骨髁上骨折手術(shù)時(shí)間短，術(shù)中透視次數(shù)少，術(shù)后總體并發(fā)癥發(fā)生率低，可獲得與閉合復(fù)位相似的肘關(guān)節(jié)功能，是治療GartlandIII型肱骨髁上骨折簡單、安全、有效的治療方法?！娟P(guān)鍵詞】肘關(guān)節(jié)；肱骨骨折；骨折固定術(shù)；兒童Comparisonofclinicalefectsofopen
4、reductionviaelbowmedialminimalincisionapproachandclosedreductioninthetreatmentofpediatricsupracondylarhumerusfractures．SUNQing-zeng，SHI一chun．DepartmentofPediatricOrthopedics，Children’sHospitalofXuzhou，Xuzhou221000，China，Co~espond-ingauthor：SUNQingzeng，E—mail：sqzjy
5、ym@163．con【Abstract】ObjetiveTocomparetheclinicalefectsofopenreductionwithelbowmedialminimalinei-sionapproachversusclosedreductioninthetreatmentofsupracondylarhumerusfractures(GartlandⅢ)inchildren．Methods124patientswhohadbeentreatedforsupracondylarhumerusfracturesi
6、nourdepartmentfromJuly2010toDecember2012wereselectedinthisstudy．Sixty-sevenpatientsweretreatedwithopenreduc·tionviaaelbowmedialminimalincision(openreductiongroup)whiletheotherfifty—sevenwithclosedreduction(closedreductiongroup)．Thetwogroupswerecomparedintermsofope
7、rativetime，intraoperativeradiographyfrequency，fracturehealingtime，F(xiàn)lynnelbowscoringat3and6monthspostoperationaswellascomplications．Results124patientswere~lowedup，andthedurationrangedfrom6to32months，withameanof18．5months．Comparedwiththeclosedreductiongroup，theopenr
8、eductiongroupneededsignificantlyshorteraverageoperativetime(50．2-4-6．81minutesversus81．3±18．98minutes)andloweraverageintraoperativeradio·graphyfrequency
