儿童肱骨髁上骨折两种不同顺序复位的疗效比较

A clinical comparison of two consequences in reduction procedure for supracondylar fractures of the humerus in children

[目的]比较儿童肱骨髁上骨折采用两种不同顺序复位的临床效果。[方法]采用前瞻性研究方法,对2008年1月～2010年11月采用切开复位的60例肱骨髁上骨折患儿,随机分成两组,术中分别采用不同的复位顺序进行复位。A组：先复位侧方移位,后复位前后移位;B组：先复位前后移位,后复位侧方移位。直视下观察两种不同顺序复位的效果。对两组患者的解剖复位成功率、获得解剖复位花费的时间及骨折端的稳定性进行比较。[结果]A组30例均在第1次复位取得解剖复位,平均花费时间3 min,25例骨折端稳定,5例不稳定。B组第1次复位6例获得解剖复位,24例失败。失败患者改变复位次序进行第2次复位后均取得解剖复位。获得解剖复位平均花费时间11min。23例骨折断端不稳定,7例稳定。两组资料的第1次解剖复位率、复位花费时间和稳定骨折端所占比例具有显著性差异。[结论]儿童肱骨髁上骨折应当按照先复位侧方移位后复位前后移位的顺序进行复位。

[Objective]To compare the clinical results between two consequences in reduction procedure for supracondylar fractures of the humerus in children.[Method]Between January 2008 to November 2010,60 children underwent open reduction for completely supracondylar fractures of the humerus in our hospital.All cases were divided into two groups by these consequence of reduction procedure.Group A：underwent the reduction of the lateral displacement,and then the anter-posteral displacement.Group B：underwent the reduction of the anter-posteral displacement,and then the lateral displacement.The quality of reduction,the anatomic reduction time,and the stability of fracture segment were statistically compared between the 2 groups.[Result]In group A： All cases received anatomic reduction.The mean anatomic reduction time was 3min,and 25cases received stability of fracture segment.In group B： 6 cases received anatomic reduction with the mean anatomic reduction time of 11 min,and 7 cases received stability of fracture segment.There was significant difference between the two groups.[Conclusion] The normal consequence should be reduction of the lateral displacement first and then the anter-posteral in maneuver procedure for supracondylar fractures of the humerus in children.