儿童肱骨远端髁上和外侧髁骨折治疗后肘关节活动范围的恢复

The recovery of elbow range of motion after treatment of supracondylar and lateral condylar fractures of the distal humerus in children

目的研究儿童肱骨髁上和外侧髁骨折后肘关节活动范围恢复所需的时间,分析肘关节活动范围的恢复和相关因素之间的关系。方法随访36例肱骨远端髁上骨折患儿和15例外侧髁骨折患儿行相应治疗。对照组20例前臂骨折患儿长臂管形石膏固定,对比无肘部骨折制动后肘关节功能恢复情况。石膏拆除后以量角器测定肘关节活动度,直至能达到健侧90%的活动度(ROM-90),同时记录恢复满足日常生活所需活动度(ROM-ADL)的时间。结果髁上骨折组恢复ROM-ADL需要23.5天,恢复ROM-90需要37.6天,外侧髁骨折组恢复ROM-ADL需要25.5天,恢复ROM-90需要36.8天。前臂骨折组,肘关节活动度恢复时间少于2周。肘部骨折后,旋后功能较旋前功能易于恢复。屈曲功能恢复最慢。结论无并发症的肱骨远端髁上和外侧髁骨折患儿拆除长臂石膏管形后,在未接受理疗的情况下,需5周的时间恢复最初的肘关节活动度。此信息可供肘部损伤患儿的医护人员进行宣教。

Objective To estimate the recovery time of eblow＇s range of motion after hu- meral supracondylar and lateral condylar fractures in children and analyze the relationship be- tween the recovery of eblow＇s range of motion and other related factors. Methods Total of 36 children with humeral supracondylar fractures and 15 children with lateral condylar fractures were treated individually and then were followed. 20 children with forearm fractures who were immo- bilized by long arm cast were used as the control group to compare elbow flexion-extension recov- ery after immobilization without elbow fracture. A goniometer measure the ROM of elbow until 90% ROM of the uninjured side had been reached and record the recovery time of ROM required for functional activity of daily living. Results Children with supracondylar fractures took 23.5 days to recover the ROM required for functional activity of daily living, and 37.6 days to get 90% ROM of the uninjured side. Children with lateral condylar fractures took 25.5 days to recover the ROM required for functional activity of daily living, and 36.8 days to get 90% ROM of the unin- jured side. The elbow ROM recovery time in children with forearm fractures was less than 2 weeks. The supination range was easier to recover than the pronation motion. The flexion reeov- cry was slowest compared to other motion. Conclusion In the uncomplicated distal humerus su- pracondylar and lateral condylar fractures, it takes 5 weeks to restore original elbow ROM after removal of long arm cast without physical therapy.