儿童肱骨髁上骨折经手法整复加闭合穿针治疗的临床疗效观察

Observation on the Clinical Curative Effect of Manipulation Reduction combined with Closed Needle in the Treatment of Supracondylar Fracture of Humerus in Children

目的探究采用手法整复加闭合穿针的方法治疗儿童肱骨髁上骨折的临床疗效。方法将2007年7月—2012年7月于我院实施"拔伸牵引旋转推挤"手法整复并经皮克氏针内固定的60例肱骨髁上骨折的患儿分为A、B两组,A组38例,行手法复位加杉树皮夹板外固定治疗法;B组22例,行手法复位加闭合穿针固定治疗法。结果随访时间0.5~6年,平均3年。按照Flynnz肘关节评分标准,优秀占50例,提携角减少角度<5°,活动度减少角度<5°;良好占7例。患儿提携角A组优良率为76.32%,B组为95.45%,两组数据差异显著,具有统计学意义(P<0.05)。肘关节屈伸功能疗效中A组优良率为71.05%,B组优良率达95.45%,两组数据差异显著,有明显的统计学意义(P<0.05)。结论经手法整复加闭合穿针疗法是治疗儿童肱骨髁上骨折完全可靠的方法,在临床观察中取得了很好的疗效,值得临床推广采用。

Objective To study the clinical curative effect of manipulation reduction combined with closed needle in the treatment of supracondylar fracture of humerus in children. Methods From July 2007 to July 2012,60 cases of supracondylar fracture of humerus in children adopted ＂stubbs stretch traction rotation pushing method of restoration＂by Kirschner wire internal fixations were divided into group A and group B. The group A of 38 cases received manipulation reduction and external fixation fir bark splint therapy. The group B of 22 cases adopted manipulation reduction and closed needle fixation therapy. Results Patients were followed up for 6 months to 6 years,an average of 3 years,in accordance with the Flynnz elbow score standard,50 cases were excellent,carrying angle reduction angle less than 5°,activity reducing angle less than 5°. 7 cases were good. The excellent and good rate of coattails angle of the group A and the group B was76. 32% and 95. 45%,respectively,and the difference between the groups was statistically significant（ P 〈0. 05）. The excellent and good rate of elbow flexion extension function of the group A and the group B was 71. 05% and 95. 45%,respectively,and the difference between the groups was statistically significant（ P〈 0. 05）. Conclusion The manipulation reduction combined with closed needle in the treatment of supracondylar fracture of humerus in children is completely reliable method,which obtained significant effect,and is worthy of clinical application.