肘后不同手术入路治疗儿童肱骨髁上骨折

The treatment of children humeral supracondylar fracture with different approach of operation behind elbow joint

目的：探讨肘后不同手术入路对儿童肱骨髁上骨折的手术治疗效果。方法：2007年1月-2010年1月收治的100例儿童肱骨髁上骨折患者,50例采取肘后肱三头肌舌状瓣切断入路（A组）,50例采取肘后肱三头肌尺骨上剥离入路（B组）,复位交叉克氏针内固定,据Aitken和Rorbeck肘关节功能评分标准分析疗效。结果：骨折均获骨性愈合,时间1~3个月,平均2个月,术后肘关节功能总体恢复满意,时间1~4个月,平均2.5个月,优秀80例,良好13例,可7例,差0例,优良率93%。肘后肱三头肌尺骨上剥离入路组的手术时间及功能恢复时间明显短于肱三头肌舌状瓣切断入路组。结论：肘后不同手术入路治疗儿童肱骨髁上骨折效果均良好,肱三头肌尺骨上剥离入路具有操作简捷、失血量较少、术时短、功能恢复快等优点。

Objective：To investigate the effect of treatment with different approach of operation in children humeral supracondylar fractures.Methods：From January 2007 to January 2010,100 children suffered from humeral supracondylar fractures were investigated.50 cases were fixation with tongue-shaped operative approach of triceps muscle of arm （group A）,50 cases were fixation with operative approach which peel triceps muscle of arm from ulna （group B）.Following open reduction of fractures and fixation with crossed K-pinning,All patients were observed during operation and followed-up for an average period of 21 months（range from 12 to 36 months）.According to Aitken and Rorbeck evaluate standard to conclude.Results：The average time of healing in all the fractures was 2 months, （from 1 to 3 months）,the average time of healing on motion of the elbow joint was 2.5 months （from 1 to 4 months）,the functional scores were excellent in 80 cases,good in 13 cases,fair in 7 cases,and poor in 0 case.The excellent-good rate was 93.0%.Group B had less time during operation and healing of motion of the elbow joint.Conclusion：The excellent or good outcomes of humeral supracondylar fracture in children could be obtained through the treatment with different approach of operation behind elbow joint. Group B had better advantages in clinical applications.