伸肘、膝位手法复位形石膏槽板固定治疗四肢长骨骨折

Manipulative reduction and fixation by a -PCS with elbow (or knee) in extension in treatment of long bone fractures of limbs

目的介绍伸肘、膝位手法复位?形石膏槽板固定治疗四肢长骨骨折。方法四肢长骨骨折置于伸肘、膝位进行手法复位,同时应用长臂(腿)?形石膏槽板绷带固定于伸肘伸膝位。上肢骨折固定3～6周,下肢固定6～10周后去石膏,逐渐恢复关节屈曲活动。结果本组188例,一次性解剖复位或功能复位173例,占96.2%,仅15例手法复位失败,改小切口手术复位有限内固定。全组经1～6年的随访,骨关节功能恢复正常,无肘(膝)内外翻畸形等并发症。结论四肢长骨于伸肘、膝位置时,肘、膝关节各拮抗肌群力效达到互为平衡,有利于骨折复位与固定,符合生物接骨理念;?形石膏槽板设计合理、结构牢靠、勿需更换,能对骨折端维持稳定的固定效果,尤其适用儿童四肢闭合性骨折治疗。

Objective To present a method of manipulative reduction and fixation by a ? shaped plaster channel slab (? PCS) with the elbow(or knee) in extension in treatment of long bone fractures of the limbs. Methods Both the manipulative reduction and the immobilization and fixation by a ? PCS of the long arm (long leg) were performed with the elbow(or knee) in extension in the treatment of the long bone fractures of the limbs. The plaster channel slab was removed after the arm fracture fixated for 3 to 6 weeks or after the leg fracture for 6 to 10 weeks. The function of the joint had been recovered gradually in 1 to 2 weeks. Results Of the 188 cases, 173 (96.2%) achieved anatomic or functional reduction at the first intention. The manipulation reduction failed in 15 cases who had to undergo operative reduction and internal fixation with a limited incision. All the cases were followed up for 1 to 6 years. The functions of the bone and joint returned to normal. None of the cases developed cubitus (knee) varus. Conclusions When the long bone of limb is in extension, the strengths of antagonistic muscle group between muscles will be well balanced and provide a favorable condition for the manipulation reduction and fixation of the fracture. With rational design and reliable structure, the ? PCS can offer stable fixation, and it is suitable especially for the treatment of closed limb fractures in children.