儿童肱骨髁上骨折不同手术入路的比较分析

Comparison and analysis of humeral supracondylar fracture operative approach in children

目的总结儿童肱骨髁上骨折不同手术入路治疗方法,为临床治疗选择提供参考。方法对60例肱骨髁上骨折患儿分别采用后侧入路(A组,20例)、外侧入路(B组,20例)及内外侧联合入路(C组,20例)3种手术方法进行治疗。记录切口显露时间、手术时间,依据Jupiter et al肘关节功能评定标准进行疗效评价。结果手术时间:A组为(78.12±8.44)min,B组为(65.42±5.67)min,C组为(58.36±4.77)min;切口显露时间:A组为(13.27±2.89)min,B组为(10.24±1.41)min,C组为(9.48±1.32)min。C组的手术时间及切口显露时间均少于A、B组(P<0.05)。功能评定:A组优良率70%(14/20),B组优良率85%(17/20),C组优良率90%(18/20),B、C组术后肘关节功能优于A组(P<0.05)。结论手术治疗儿童肱骨髁上骨折,后侧入路不应作为常规首选,外侧入路为有效可靠选择,内外侧联合入路效果更好。

Objective To summarize the operation and therapy results of humeral supracondylar fracture operative approach in children,providing good reference in clinical choosing operation and therapy methods for these patients.Methods 60 cases with humeral supracondylar fracture were operated via post approach（A group,20 cases）,lateral approach（B group,20 cases）,and exterior and interior association approach（C group,20 cases）.The exposure time,operation time,function recovery according to Jupiter et al joint elbow function system were recorded.Results The operation time of A group,B group and C group were（78.12±8.44） min,（65.42±5.67） min and（58.36±4.77） min;the exposure time was（13.27±2.89） min,（10.24±1.41） min and（9.48±1.32） min.The operation time and exposure time were shorter in C group than A,B（P〈0.05）.The function was 70% excellent and good in A group（14/20）,85% in B group（17/20）,and 90% in C group（18/20）.Both results in B and C were better than A（P〈0.05）.Conclusions To cure humeral supracondylar fracture in children by operation,post approach is not the routine first choice,lateral approach is the effective and reliability one,and exterior and interior association approach deserves clinical spreading for its satisfied results.