CAJ | 학술논문

目的：总结两种手术入路治疗儿童肱骨髁上骨折的疗效，为临床治疗儿童肱骨髁上骨折的手术入路选择提供参考。方法对60例GartlandⅢ型肱骨髁上骨折患儿采用随机抽样方法分别予正后侧入路（ A组，30例）和外侧入路（ B组，30例）两种手术入路进行治疗。记录切口显露时间、切口闭合时间和手术时间，并依据Flynn标准对肘关节功能疗效进行评价。结果切口显露时间：A组为（14.48±1.33） min，B组为（10.27±1.28）min；切口闭合时间：A组为（20.60±1.83）min，B组为（17.00±1.36）min；手术时间：A组为（80.27±3.16） min，B组为（67.50±2.10） min。 B组的切口显露时间、切口闭合时间、手术时间均短于A组，差异具有统计学意义（ P＜0.05）；肘关节功能评定A组优良率为73.3％，B组为93.3％，B组术后肘关节功能优于A组（P＜0.05）。结论对于GartlandⅢ型骨折且手法复位困难的患儿，切开复位克氏针内固定治疗儿童肱骨髁上骨折是一种可行的方法。经肘关节外侧入路在切口显露时间、切口闭合时间、手术时间均短于正后侧入路，且术后肘关节功能较后侧入路佳，可作为更为有效、可靠的选择。
목적：총결량충수술입로치료인동굉골과상골절적료효，위림상치료인동굉골과상골절적수술입로선택제공삼고。방법대60례GartlandⅢ형굉골과상골절환인채용수궤추양방법분별여정후측입로（ A조，30례）화외측입로（ B조，30례）량충수술입로진행치료。기록절구현로시간、절구폐합시간화수술시간，병의거Flynn표준대주관절공능료효진행평개。결과절구현로시간：A조위（14.48±1.33） min，B조위（10.27±1.28）min；절구폐합시간：A조위（20.60±1.83）min，B조위（17.00±1.36）min；수술시간：A조위（80.27±3.16） min，B조위（67.50±2.10） min。 B조적절구현로시간、절구폐합시간、수술시간균단우A조，차이구유통계학의의（ P＜0.05）；주관절공능평정A조우량솔위73.3％，B조위93.3％，B조술후주관절공능우우A조（P＜0.05）。결론대우GartlandⅢ형골절차수법복위곤난적환인，절개복위극씨침내고정치료인동굉골과상골절시일충가행적방법。경주관절외측입로재절구현로시간、절구폐합시간、수술시간균단우정후측입로，차술후주관절공능교후측입로가，가작위경위유효、가고적선택。
Objective To compare and analyze the therapeutic results of humeral supracondylar fracture by two kinds of operative approaches.Methods Sixty cases with humeral supracondylar fracture were operated by using posterior approach( Group A, n=30 ) and by using lateral approach ( Group B, n=30 ) .The exposure time, the closing time and the operation time were recorded and the function recovery was evaluated according to Flynn joint el-bow function system.Results The exposure time was (14.48 ±1.33) min in group A and (10.27 ±1.28) min in group B;The closed time was (20.60 ±1.83)min in group A and (17.00 ±1.36)min in group B; The operation time was (80.27 ±3.16)min in group A and (67.50 ±2.10)min in group B.The exposure time, the closing time and the operation time were shorter in group B than those in group A.73.3% patients showed excellent or good re-sults in the function of elbow joints in group A and 93.3%in group B, with a significant difference between the two groups(P<0.05).Conclusion It is a practical approach to use open reduction and internal fixation with kirschner pin for patients with GartlandⅢ humeral supracondylar fracture who are difficult in performing manipulative reduc-tion.The effect of the surgery by lateral apporach is better than that by posterior approach for children with humeral supracondylar fracture.