牵引配合手法治疗肱骨髁上及髁间骨折治疗效果观察

Treatment of supracondylar and intercondylar fracture of humerus by traction combined with manipulation therapy

目的观察尺骨鹰嘴牵引配合手法治疗肱骨髁上及髁间骨折的效果。方法选取2008年5月-2015年2月于医院诊治的肱骨髁上骨折患儿31例和肱骨髁上及髁间骨折患儿5例,共36例作为研究对象,采取尺骨鹰嘴牵引配合手法治疗,治疗后对所有患儿进行随访,评估、记录骨折愈合情况、患肢屈伸功能、畸形情况及功能恢复情况等。结果对所有研究对象随访2~8年,中位数4年,36例患儿骨折临床愈合时间为20~110 d,中位数40 d,无骨不连发生;采用Mayo评分系统对治疗后患者的肘关节功能情况进行评定,康复优良率为86.1%;治疗并发症发生情况:轻度内外翻畸形者8例(22.2%),中度畸形者2例(5.6%),重度畸形者1例(2.8%)。结论少年儿童骨折愈合较快,可塑性强,适合采用尺骨鹰嘴牵引手法治疗,且该疗法不需复杂设备和技术,值得在基层医院推广应用。

Objective To observe the effect of olecranon traction combined with manipulation in the treatment of supracondylar and intercondylar fractures of humerus. Methods 31 cases with supracondylar fracture of humerus and 5 cases of supracondylar and intercondylar fracture of humerus in the hospital from May 2008 to February 2015 were enrolled in this study. A total of 36 cases were treated with olecranon traction with manipulation treatment. After the treatment,all children were followed up,the fracture healing,limb flexion,extension function,deformity and functional recovery were assessed and recorded.Results All the subjects were followed up for 2 to 8 years,with a median of 4 years. The fracture healing time of 36 cases was20 ~ 110 days,the median was 40 days,and no bone nonunion occurred. The Mayo scoring system was used to evaluate the function of the elbow joint in the patients after treatment. Satisfying rate of rehabilitation was 86. 1%. Complications： mild deformity in 8 cases（22. 2%）,moderate deformity in 2 cases（5. 6%）,severe deformity in 1 case（2. 8%）. Conclusion Fracture in children heals fast,and children＇s bones are of plasticity,so traction manipulation is suitable. Moreover,without complex equipment and technology,this therapy is worth to be popularized at primary hospitals.