肱骨近端骨折患儿的外科治疗方案研究

Surgical Treatment of Proximal Humeral Fractures in Children

目的:探讨切开复位克氏针内固定和切开复位外固定架治疗儿童肱骨近端骨折的临床效果和并发症。方法:选取2013年1月-2015年1月于本院住院治疗的64例肱骨近端骨折患儿,根据手术治疗方法分为两组,切开复位克氏针固定组36例,切开复位外固定架组28例,比较两种外科治疗方案对患儿的治疗效果。结果:两组患儿住院时间、骨折愈合时间、术后并发症比较差异无统计学意义(P>0.05);固定架组手术时间、手术出血量和切口长度少于克氏针组,两组比较差异均有统计学意义(P<0.05)。固定架组术后Neer评分及术后1、2、3个月骨折愈合率均高于克氏针组,两组比较差异有统计学意义(P<0.05)。克氏针组患儿主观满意度为80.6%,低于固定架组100%,两组比较差异有统计学意义(P<0.05)。结论:切开复位外固定架治疗儿童肱骨近端骨折对于损伤严重、移位严重的患者是较好的治疗方式,手术操作简单、损伤小,有利于患儿的上肢恢复和早期功能锻炼。

Objective：To investigate the clinical effects and complications of open reduction and internal fixation with open reduction and internal fixation for the treatment of proximal humerus fractures in children.Method：64 patients with proximal humerus fractures were selected from January 2013 to January 2015,they were divided into Kirschner wire group of 36 cases which were given open reduction Kirschner fixation,and external fixation group of 28 cases which were given open reduction external fixation.The therapeutic effect of two kinds surgical treatment were compared.Result：Two groups of children with hospitalization time,fracture healing time and postoperative complications had no significant difference（P〉0.05）.The operation time, bleeding volume and incision length of fixation group were less than Kirschner wire group（P〈0.05）.After operation,the Neer score in fixation group was higher than Kirschner wire group,the healing rates of fracture after operation 1, 2 and 3 months in fixation group were higher than Kirschner wire group,the differences were statistically significant（P〈0.05）.The subjective satisfaction rate was 80.6% in Kirschner wire group,lower than that of the fixed frame group 100%,the difference was statistically significant（P〈0.05）.Conclusion：Open reduction and external fixation for the treatment of children with fractures of the proximal humerus is a better treatment for injury severity and severe displacement,it is simple operation,little injury,and conducive to children＇s upper limb rehabilitation and early functional exercise.