中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2014年
2期
124-126
,共3页
儿童%骨折固定术,内%肱骨髁上骨折%功能评价%手术入路
兒童%骨摺固定術,內%肱骨髁上骨摺%功能評價%手術入路
인동%골절고정술,내%굉골과상골절%공능평개%수술입로
Children%Fracture fixation,internal%Supracondylar humeral fracture%Functional assessment%Surgical approach
目的 比较两种手术入路对复杂的小儿肱骨髁上骨折疗效的影响.方法 随访2010年7月至2011年12月采用肘后入路切开复位克氏针内固定治疗的34例复杂的肱骨髁上骨折患儿.随访时间16～ 32个月,平均(21.7±4.4)个月.按照肱三头肌不同的处理方法,将病例分为肱三头肌正中切开入路组(A组),肱三头肌旁入路组(B组).A组19例,B组15例.随访内容:两侧肘关节活动度(屈曲、背伸),前臂旋前、旋后活动范围;提携角,两侧伸肘肌力;影像学资料(Baumann角、肱骨干髁角);Mayo肘关节功能评分.记录随访结果,并对最后一次随访结果进行统计学分析.结果 两组病例中肘关节活动度及前臂旋前、旋后活动范围均在正常范围,两组间差异无统计学意义.计算患侧伸肘肌力与健侧的百分比,两组间差异无统计学意义.Mayo肘关节功能评分均为100分,两组间差异无统计学意义.测量Baumann角、肱骨干髁角,两组的均值均在正常范围内,两组间的差异无统计学意义.结论 肱三头肌旁及肱三头肌正中切开两种入路在小儿肱骨髁上骨折治疗中具有相同的疗效.
目的 比較兩種手術入路對複雜的小兒肱骨髁上骨摺療效的影響.方法 隨訪2010年7月至2011年12月採用肘後入路切開複位剋氏針內固定治療的34例複雜的肱骨髁上骨摺患兒.隨訪時間16～ 32箇月,平均(21.7±4.4)箇月.按照肱三頭肌不同的處理方法,將病例分為肱三頭肌正中切開入路組(A組),肱三頭肌徬入路組(B組).A組19例,B組15例.隨訪內容:兩側肘關節活動度(屈麯、揹伸),前臂鏇前、鏇後活動範圍;提攜角,兩側伸肘肌力;影像學資料(Baumann角、肱骨榦髁角);Mayo肘關節功能評分.記錄隨訪結果,併對最後一次隨訪結果進行統計學分析.結果 兩組病例中肘關節活動度及前臂鏇前、鏇後活動範圍均在正常範圍,兩組間差異無統計學意義.計算患側伸肘肌力與健側的百分比,兩組間差異無統計學意義.Mayo肘關節功能評分均為100分,兩組間差異無統計學意義.測量Baumann角、肱骨榦髁角,兩組的均值均在正常範圍內,兩組間的差異無統計學意義.結論 肱三頭肌徬及肱三頭肌正中切開兩種入路在小兒肱骨髁上骨摺治療中具有相同的療效.
목적 비교량충수술입로대복잡적소인굉골과상골절료효적영향.방법 수방2010년7월지2011년12월채용주후입로절개복위극씨침내고정치료적34례복잡적굉골과상골절환인.수방시간16～ 32개월,평균(21.7±4.4)개월.안조굉삼두기불동적처리방법,장병례분위굉삼두기정중절개입로조(A조),굉삼두기방입로조(B조).A조19례,B조15례.수방내용:량측주관절활동도(굴곡、배신),전비선전、선후활동범위;제휴각,량측신주기력;영상학자료(Baumann각、굉골간과각);Mayo주관절공능평분.기록수방결과,병대최후일차수방결과진행통계학분석.결과 량조병례중주관절활동도급전비선전、선후활동범위균재정상범위,량조간차이무통계학의의.계산환측신주기력여건측적백분비,량조간차이무통계학의의.Mayo주관절공능평분균위100분,량조간차이무통계학의의.측량Baumann각、굉골간과각,량조적균치균재정상범위내,량조간적차이무통계학의의.결론 굉삼두기방급굉삼두기정중절개량충입로재소인굉골과상골절치료중구유상동적료효.
Objective To compare the results between two surgical approaches for treating complex supracondylar humeral fractures in children.Methods Open reduction and internal fixation with Kirschner-wires were carried out through a posterior incision around the elbow to treat 34 cases of pediatric displaced supracondylar humeral fractures from July 2010 to December 2011.These cases were divided into two groups based on the way with which the triceps brachii was managed.In group A (triceps-splitting approach) the triceps was split in the midline to allow access,while in group B (paratricipital approach) access was gained via a lateral triceps approach.The patients were follow-up postoperatively for 16 to 32 months,with an average of 21.7 months.Objective and subjective functional results (elbow range of motion including flexion/extension and pronation/supination,the strength of triceps muscle,carrying angle,Mayo Elbow Performance Score) and radiographic data (Baumarm angle,humerocapitellar angle) were assessed.The last follow-up evaluations were compared between the two groups.Results Elbow range of motion,carying angle,Baumann angle and humerocapitellar angle were in the normal range for both groups.There was no difference between the two groups.No significant difference was found between the two groups in the percent strength of triceps muscle normalized against the healthy side.Both groups achieved 100 Mayo Elbow Score showing no differences between the groups.Conclusion The triceps-splitting approach and paratricipital approach have comparable clinical results when used to treat pediatric displaced supracondylar humeral fractures.
