肱骨髁上骨折并发症分析

Analysis of Complications of Supracondylar Fracture of Humerus

目的探讨肱骨髁上骨折治疗后的并发症。方法方便选取2014年6月—2017年6月该院收治的肱骨髁上骨折患儿108例作为研究对象,按照随机数字表达法将其分为研究组(n=54)和对照组(n=54)两组,家长拒绝手术要求手法复位石膏外固定者纳入对照组,研究组患儿应用闭合复位克氏针内固定术进行治疗,将治疗结束后两组患儿的治疗有效率以及并发生发生率进行对比。结果研究组有效率为94.4%,对照组患儿的有效率为88.8%,由此可得研究组患儿有效率明显高于对照组(χ2=5.932,P<0.05);研究组患儿血管损伤、神经损伤、骨筋膜室综合征、骨化性肌炎、针管感染以及肘内翻畸形等并发症发生率为3.7%,对照组并发症发生率为18.5%,由此可得对照组患儿并发症发生率明显高于研究组(χ2=6.831,P<0.05)。结论在肱骨髁上骨折患儿的治疗过程当中,特别是骨折移位明显的病例,有限选择闭合复位克氏针内固定术,拒绝手术者采用闭合复位石膏外固定治疗,治疗后应用闭合复位克氏针内固定治疗的患儿临床症状改善情况较闭合复位石膏外固定法好,治疗效果较满意,大大降低了并发症的发生率,值得临床上加以推广和应用。

Objective To investigate the complications of supracondylar fracture of the humerus.Methods A total of 108 children with supracondylar fractures of the humerus admitted to the hospital from June 2014 to June 2017 were convenient enrolled.The patients were divided into study group(n=54)and control group(n=54)according to random number expression.In the two groups,the parents refused to require surgery to reset the external plaster fixation into the control group,and the study group was treated with closed reduction and Kirschner wire internal fixation.The treatment of the two groups was effective and occurrance rate after the treatment was compared.Results The effective rate of the study group was 94.4%,and the effective rate of the control group was 88.8%.The effective rate of the study group was significantly higher than that of the control group(χ^2=5.932,P<0.05);the incidence of vascular injury,nerve injury,compartment syndrome,ossifying myositis,needle infection and elbow varus deformity in the study group was 3.7%.The incidence rate was 18.5%,and the incidence of complications in the control group was significantly higher than that in the study group(χ^2=6.831,P<0.05).Conclusion In the treatment of children with supracondylar fractures of the humerus,especially in patients with obvious fracture displacement,limited selection of closed reduction and Kirschner wire internal fixation is used.Patients who refuse surgery are treated with closed reduction and external fixation.The improvement of clinical symptoms in children treated with internal fixation is better than that of closed reduction and external fixation.The treatment effect is satisfactory,which greatly reduces the incidence of complications.It is worthy of clinical promotion and application.