儿童肱骨髁上骨折3种手术入路比较

Comparison of three approaches for the treatment of supracondylar fracture of humerus in children

目的 比较肱三头肌舌状瓣入路、肘外侧入路、肱三头肌两侧入路治疗儿童肱骨髁上骨折的疗效。方法 采用肱三头肌舌状瓣入路治疗 33例 ,肘外侧入路治疗 2 0例 ,肱三头肌两侧入路治疗 5 5例。结果 随访 10 5例 ,时间为 1～ 8年。优良率 :肱三头肌舌状瓣入路为 6 3 3% ,肘外侧入路为70 % ,肱三头肌两侧入路为 92 7%。肱三头肌两侧入路与其它两种入路相比差异有显著性 (P <0 0 1)。

Objective To compare the results of treatment for the supracondylar fracture of humerus in children through lingulate triceps brachii approach; lateral elbow and bilateral triceps brachii. Methods 33 cases of fracturtes were treated through lingulate flap of triceps brachii approach, 20 cases through lateral elbow and 55 cases through bilateral triceps brachii approach. Results 105 patients were followed up for 1～8 years. The excellent and good rate was 63 3% in the group of lingulate flap of triceps brachii, 70% in the group of lateral elbow and 92 7% in the group of bilateral triceps brachii approach. There were significant statistic differences between the excellent and good rates of bilateral triceps brachii approach group and the other two groups( P< 0 01). Conclusion The bilateral triceps brachii approach could be regarded as the first choice for operating treatment of the supracondylar fracture of humerus in children.