摘要
目的:比较AO克氏针张力带与髌骨针张力带内固定治疗儿童GartlandⅢ型肱骨髁上骨折的临床疗效。方法:回顾性分析41例儿童GartlandⅢ型肱骨髁上骨折患者的病例资料,其中18例采用AO克氏针张力带内固定(克氏针组)、23例采用髌骨针张力带内固定(髌骨针组)。男26例,女15例。年龄4~12岁,中位数7岁。比较2组患者的手术时间、术中出血量、术后住院时间、骨折愈合时间以及术后6个月参照Flynn肘关节功能评分标准评价的临床疗效。结果:所有患者均获随访,随访时间8~24个月,中位数18个月。髌骨针组的手术时间、术后住院时间、骨折愈合时间均短于克氏针组[(54.35±4.00)min,(63.56±5.39)min,t=2.186,P=0.035;(4.57±1.27)d,(6.06±2.41)d,t=2.375,P=0.026;(52.91±3.86)d,(56.78±5.92)d,t=2.524,P=0.016];2组患者的术中出血量比较,差异无统计学意义[(52.83±7.04)mL,(55.00±7.86)mL,t=0.932,P=0.357]。术后6个月参照Flynn肘关节功能评分标准评价临床疗效,克氏针组优10例、良5例、可1例、差2例,髌骨针组优14例、良8例、可1例;2组患者的临床疗效比较,差异无统计学意义(Z=0.630,P=0.471)。结论:AO克氏针张力带与髌骨针张力带内固定治疗儿童GartlandⅢ型肱骨髁上骨折,临床疗效相当,均可促进肘关节功能恢复,但髌骨针张力带内固定具有手术时间及术后住院时间短、骨折愈合快的优点。
Objective:To compare the clinical curative effects of internal fixation with AO Kirschner wire tension band versus patella needle tension band in treatment of Gartland typeⅢhumeral supracondylar fractures in children.Methods:The medical records of 41 children with Gartland typeⅢhumeral supracondylar fractures were analyzed retrospectively.Eighteen children were treated with AO Kirschner wire tension band internal fixation(Kirschner wire group),while the others were treated with patella needle tension band internal fixation(patella needle group).The children consisted of 26 boys and 15 girls,and ranged in age from 4 to 12 years(Median=7 yrs).The operative time,intraoperative blood loss,postoperative hospital stay,fracture healing time and clinical curative effects evaluated according to Flynn elbow performance score at 6 months after surgery were compared between the 2 groups.Results:All children in the 2 groups were followed up for 8-24 months with a median of 18 months.The operative time,postoperative hospital stay and fracture healing time were shorter in patella needle group compared to Kirschner wire group(54.35+/-4.00 vs 63.56+/-5.39 min,t=2.186,P=0.035;4.57+/-1.27 vs 6.06+/-2.41 days,t=2.375,P=0.026;52.91+/-3.86 vs 56.78+/-5.92 days,t=2.524,P=0.016).There was no statistical difference in intraoperative blood loss between the 2 groups(52.83+/-7.04 vs 55.00+/-7.86 ml,t=0.932,P=0.357).According to Flynn elbow performance scores evaluated at 6 months after surgery,10 children obtained an excellent result,5 good,1 fair and 2 poor in Kirschner wire group;while 14 children obtained an excellent result,8 good and 1 fair in patella needle group;There was no statistical difference in the clinical curative effects between the 2 groups(Z=0.630,P=0.471).Conclusion:Internal fixation with AO Kirschner wire tension band and internal fixation with patella needle tension band are similar to each other in the clinical curative effects in treatment of Gartland typeⅢhumeral supracondylar fractures in children.Both of them can promote the recovery of elbow function,however,the latter has such advantages as shorter operative time and postoperative hospital stay and faster fracture healing.
作者
吴博
季卫平
王波
许超
WU Bo;JI Weiping;WANG Bo;XU Chao(The People's Hospital of Lishui City,Lishui 323000,Zhejiang,China)
出处
《中医正骨》
2017年第12期34-37,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
肱骨骨折
骨折固定术
内
儿童
humeral fractures
fracture fixation,internal
child
