中国骨伤
中國骨傷
중국골상
CHINA JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
2013年
8期
656-658
,共3页
李伟强%郭跃明%何健%卢凤珊
李偉彊%郭躍明%何健%盧鳳珊
리위강%곽약명%하건%로봉산
肱骨骨折%肘%畸形%外固定器%儿童
肱骨骨摺%肘%畸形%外固定器%兒童
굉골골절%주%기형%외고정기%인동
Humeral fractures%Elbow%Abnormalities%External fixators%Child
目的：使用自行研制的动力型肘关节支具，通过观察其患健侧Baumann角（B角）角度差的变化，评估其用于预防儿童肱骨髁上骨折并发肘内翻的作用。方法：2010年10月至2012年4月X线片诊断为GartlandⅡ、Ⅲ型闭合性肱骨髁上骨折患者共120例，分为治疗组和与对照组。治疗组62例，男48例，女14例，年龄（7．27±4．36）岁，病程（1．48±1．26） d；对照组58例，其中男47例，女11例，年龄（8．02±3．82）岁，病程（1．20±1．11） d。治疗组和对照组均采用手法整复、小夹板外固定。治疗组复位15 d后使用肘支具，直至90 d观察结束。对照组使用小夹板外固定，30 d后去除小夹板。两组于复位后即刻、15 d、30 d、60 d、90 d、6个月、1年拍X线片测量B角，复位后同时摄健侧X线片测量健侧B角，并计算患侧与健侧B角差。复位后90 d及1年时参照Flynn标准进行肘关节功能评价。结果：所有病例有1年以上随访，均达到骨折治愈标准。随访肘内翻发生情况：治疗组无，对照组4例。患健侧B角差随时间的推移有逐渐增大的趋势，复位后30 d开始至90 d对照组B角差增加的幅度比治疗组大（P＜0．01）。结论：应用动力型弹性外固定支具对稳定肱骨髁上骨折中后期B角有确定性效果。
目的：使用自行研製的動力型肘關節支具，通過觀察其患健側Baumann角（B角）角度差的變化，評估其用于預防兒童肱骨髁上骨摺併髮肘內翻的作用。方法：2010年10月至2012年4月X線片診斷為GartlandⅡ、Ⅲ型閉閤性肱骨髁上骨摺患者共120例，分為治療組和與對照組。治療組62例，男48例，女14例，年齡（7．27±4．36）歲，病程（1．48±1．26） d；對照組58例，其中男47例，女11例，年齡（8．02±3．82）歲，病程（1．20±1．11） d。治療組和對照組均採用手法整複、小夾闆外固定。治療組複位15 d後使用肘支具，直至90 d觀察結束。對照組使用小夾闆外固定，30 d後去除小夾闆。兩組于複位後即刻、15 d、30 d、60 d、90 d、6箇月、1年拍X線片測量B角，複位後同時攝健側X線片測量健側B角，併計算患側與健側B角差。複位後90 d及1年時參照Flynn標準進行肘關節功能評價。結果：所有病例有1年以上隨訪，均達到骨摺治愈標準。隨訪肘內翻髮生情況：治療組無，對照組4例。患健側B角差隨時間的推移有逐漸增大的趨勢，複位後30 d開始至90 d對照組B角差增加的幅度比治療組大（P＜0．01）。結論：應用動力型彈性外固定支具對穩定肱骨髁上骨摺中後期B角有確定性效果。
목적：사용자행연제적동력형주관절지구，통과관찰기환건측Baumann각（B각）각도차적변화，평고기용우예방인동굉골과상골절병발주내번적작용。방법：2010년10월지2012년4월X선편진단위GartlandⅡ、Ⅲ형폐합성굉골과상골절환자공120례，분위치료조화여대조조。치료조62례，남48례，녀14례，년령（7．27±4．36）세，병정（1．48±1．26） d；대조조58례，기중남47례，녀11례，년령（8．02±3．82）세，병정（1．20±1．11） d。치료조화대조조균채용수법정복、소협판외고정。치료조복위15 d후사용주지구，직지90 d관찰결속。대조조사용소협판외고정，30 d후거제소협판。량조우복위후즉각、15 d、30 d、60 d、90 d、6개월、1년박X선편측량B각，복위후동시섭건측X선편측량건측B각，병계산환측여건측B각차。복위후90 d급1년시삼조Flynn표준진행주관절공능평개。결과：소유병례유1년이상수방，균체도골절치유표준。수방주내번발생정황：치료조무，대조조4례。환건측B각차수시간적추이유축점증대적추세，복위후30 d개시지90 d대조조B각차증가적폭도비치료조대（P＜0．01）。결론：응용동력형탄성외고정지구대은정굉골과상골절중후기B각유학정성효과。
Objective:To evaluate the function of preventing supracondylar fracture of the humerus and cubitus varus in children by observing Baumann angle changes with self-made Orthopedic elastic elbow brace. Methods:From October 2010 to April 2012,120 patients with closed GartlandⅡor III supracondylar fracture of the humerus diagnoised by X ray were divided into two groups as follows:group A (62 cases,including 48 males and 14 females,with an average age of (7.27±4.36) years old,and the course of (1.48±1.26) days);group B (58 cases,including 47 males and 11 females,with an average age of (8.02±3.82) years old,and the course of (1.20±1.11) days. The two groups were treated by manipulative reduction and exter-nal fixation of small splints. Group A were used with elbow brace at 15 days after reduction ,and treated for 90 days. Group B were used with external fixation of small splints and removed at 30 days. Baumann angle changes at different time periods (15 days,30 days,60 days,90 days,6 months,1 year) after reduction and its'opposite side were recorded by X ray. The angles of injured side and the opposite side were compared. The function of the elbow brace was evaluated at 90 days or 1 year after re-duction according to Flynn. Results:All cases were followed up for over 1 year and obtained fracture healing. The incidence of cubitus varus was no one in group A and 4 cases in group B. The Baumann angles of injured side were trended to be increased with the time passing. From 30 days after reduction to 90 days ,the increased angles of group B is more than that of group A (P<0.01). Conclusion:It is effective on stabilizing Baumman angle in the supracondylar fracture of the humerus of midanaphase treatment in Children by orthopedic elastic elbow brace.
