中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
20期
17-19
,共3页
儿童%肱骨骨折%关节镜检查%内固定器
兒童%肱骨骨摺%關節鏡檢查%內固定器
인동%굉골골절%관절경검사%내고정기
Child%Humeral fractures%Arthroscopy%Internal fixators
目的 探讨肘关节镜监控下经皮克氏针固定治疗儿童肱骨外髁骨折的疗效.方法 将128例肱骨外髁骨折患儿根据入院先后顺序随机分为两组:切开复位组64例,采用切开复位克氏针固定治疗;关节镜组64例,采用肘关节镜监控下闭合复位经皮克氏针固定治疗.对两组的手术情况、术后随访等进行比较.结果 128例全部获得12～24个月的随访,平均(18.07±5.63)个月.关节镜组的术中出血量为(34.6±9.1)ml、切口长度为(0.98±0.20)cm、术后第3天视觉模拟疼痛评分(VAS)为(3.99±1.33)分,切开复位组分别为(109.9±18.9)ml、(5.38±1.30)cm、(7.03±2.80)分,两组比较差异有统计学意义(P<0.01或<0.05).根据Mayo肘关节功能评分切开复位组优良率为85.9%(55/64),关节镜组优良率为98.4%(63/64),两组比较差异有统计学意义(P<0.05).术后切开复位组延迟愈合8例,肘关节内外翻畸形5例,钉道感染9例;关节镜组分别为1、2、1例,两组比较差异有统计学意义(P<0.01).结论 肘关节镜监控下闭合复位经皮克氏针固定治疗儿童肱骨外髁骨折具有切口小、复位准确、并发症少等优点.
目的 探討肘關節鏡鑑控下經皮剋氏針固定治療兒童肱骨外髁骨摺的療效.方法 將128例肱骨外髁骨摺患兒根據入院先後順序隨機分為兩組:切開複位組64例,採用切開複位剋氏針固定治療;關節鏡組64例,採用肘關節鏡鑑控下閉閤複位經皮剋氏針固定治療.對兩組的手術情況、術後隨訪等進行比較.結果 128例全部穫得12～24箇月的隨訪,平均(18.07±5.63)箇月.關節鏡組的術中齣血量為(34.6±9.1)ml、切口長度為(0.98±0.20)cm、術後第3天視覺模擬疼痛評分(VAS)為(3.99±1.33)分,切開複位組分彆為(109.9±18.9)ml、(5.38±1.30)cm、(7.03±2.80)分,兩組比較差異有統計學意義(P<0.01或<0.05).根據Mayo肘關節功能評分切開複位組優良率為85.9%(55/64),關節鏡組優良率為98.4%(63/64),兩組比較差異有統計學意義(P<0.05).術後切開複位組延遲愈閤8例,肘關節內外翻畸形5例,釘道感染9例;關節鏡組分彆為1、2、1例,兩組比較差異有統計學意義(P<0.01).結論 肘關節鏡鑑控下閉閤複位經皮剋氏針固定治療兒童肱骨外髁骨摺具有切口小、複位準確、併髮癥少等優點.
목적 탐토주관절경감공하경피극씨침고정치료인동굉골외과골절적료효.방법 장128례굉골외과골절환인근거입원선후순서수궤분위량조:절개복위조64례,채용절개복위극씨침고정치료;관절경조64례,채용주관절경감공하폐합복위경피극씨침고정치료.대량조적수술정황、술후수방등진행비교.결과 128례전부획득12～24개월적수방,평균(18.07±5.63)개월.관절경조적술중출혈량위(34.6±9.1)ml、절구장도위(0.98±0.20)cm、술후제3천시각모의동통평분(VAS)위(3.99±1.33)분,절개복위조분별위(109.9±18.9)ml、(5.38±1.30)cm、(7.03±2.80)분,량조비교차이유통계학의의(P<0.01혹<0.05).근거Mayo주관절공능평분절개복위조우량솔위85.9%(55/64),관절경조우량솔위98.4%(63/64),량조비교차이유통계학의의(P<0.05).술후절개복위조연지유합8례,주관절내외번기형5례,정도감염9례;관절경조분별위1、2、1례,량조비교차이유통계학의의(P<0.01).결론 주관절경감공하폐합복위경피극씨침고정치료인동굉골외과골절구유절구소、복위준학、병발증소등우점.
Objective To investigate the effect of the treatment of humeral lateral condyle fracture in children through elbow arthroscopy. Method From July 2003 to May 2008, 128 children with humeral lateral condyle fracture were randomly divided into open reduction group and arthroscopy group, each group of 64 cases. Results All 128 children received 12-24 months of follow up, with average of (18.07 ± 5.63) months. In arthroscopy group, the blood loss averaged(34.6 ± 9.1) ml, incision length of(0.98 ± 0.20) cm, and after the first 3 days the VAS was(3.99 ± 1.33) scores. However, in open reduction group, the blood loss averaged (109.9 ± 18.9) ml, incision length of (5.38 ± 1.30) cm, and the VAS was (7.03 ± 2.80) scores. All those in arthroscopy group were much better than those in open reduction group,the differences were statistically significant (P<0.01 or < 0.05). According to Mayo score, the total fine rate was 85.9%(55/64) in open reduction group, and 98.4%(63/64) in arthroscopy group (P<0.05). About in the incidence of postoperative complications,there were 8 cases of delayed healing, S cases of inside inversion or outside eversion elbow varus deformity, 9 cases of pin tract infection in open reduction group. However there were 1 cage of delayed healing, 2 cases of inside inversion and outside eversion elbow varus deformity, 1 case of pin tract infection in arthroscopy group(P< 0.01). Conclusion Arthroscopy operation has the advantages of the small incision, reset reduction accurate, less complications ,and is an effective method of treating the lateral condyle fractures in children.
