儿童后中侧和后外侧移位肱骨髁上骨折和肘内翻畸形之间的关系

Relationship Between Children Posterior Medial and Posterior Lateral Displacement of Supracondylar Fracture of Humerus and Cubitus Varus

目的探讨儿童后中侧和后外侧移位肱骨髁上骨折和肘内翻畸形之间的关系。方法对2008年6月至2010年6月于我院行闭合复位克氏针内固定术的206例肱骨髁上骨折患儿进行回顾性分析,其中16例出现肘内翻畸形,分为后中侧移位组10例和后外侧移位组6例,观察比较两组的肘内翻角度和肘关节功能。结果肱骨髁上骨折并发肘内翻畸形者占7.8%,后中侧移位组术后肘内翻平均角度为16.2°±3.9°,后外侧移位组术后肘内翻平均角度为8.6°±4.1°,前组较后组患儿肘内翻畸形更加明显,两组相比差异具有统计学意义(P<0.05)。根据Flynn标准,所有患儿均未出现肘关节活动受限。结论完全移位的肱骨髁上骨折即使手术治疗达到解剖复位,随患儿的功能恢复和生长发育也可能发生肘内翻畸形。其中,后中侧骨折移位发生的肘内翻畸形较后外侧骨折移位明显,对肘功能影响更大。

Objective To explore the relationship between children posterior medial and posterior lateral displacement of supracondylar fracture of humerus and cubitus varus. Methods 206 children with supracondylar fracture of humerus treated with closed reduction and Kirschner wire internal fixation in our hospital from June 2008 to June 2010 were selected, in which, 16 cases of cubitus varus were selected as the research objects, and divided into posterior medial displacement group（n = 10） and posterior lateral displacement group（n = 6）. The cubitus varus angle and elbow function of two groups were observed and compared. Results The incidence of supracondylar fracture of humerus complicated with cubitus varus was 7.8%（16/206）. The average cubitus varus angle of posterior medial displacement group was 16.2° ± 3.9°, significantly higher than 8.6° ± 4.1° of posterior lateral displacement group（P〈0.05）. According to Flynn standard,no patient experienced elbow limited mobility. Conclusions Complete displacement of humeral fractures may appear cubitus varus with children＇s functional recovery and growing development, even though they are operated and reach anatomical reduction. Among them,comparing with posterior lateral displacement of supracondylar fracture of humerus, posterior medial displacement of supracondylar fracture of humerus is easier to appear cubitus varus and has greater influence on elbow function.