[1]吴博,季卫平,王波,等.AO克氏针张力带与髌骨针张力带内固定治疗儿童GartlandⅢ型肱骨髁上骨折的对比研究…[J].中医正骨,2017,29(12):34-37.
 WU Bo,JI Weiping,WANG Bo,et al.A comparative study of internal fixation with AO Kirschner wire tension band versus patella needle tension band for treatment of Gartland typeⅢhumeral supracondylar fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(12):34-37.
点击复制

AO克氏针张力带与髌骨针张力带内固定治疗儿童GartlandⅢ型肱骨髁上骨折的对比研究…()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年12期
页码:
34-37
栏目:
临床研究
出版日期:
2017-12-20

文章信息/Info

Title:
A comparative study of internal fixation with AO Kirschner wire tension band versus patella needle tension band for treatment of Gartland typeⅢhumeral supracondylar fractures in children
作者:
吴博季卫平王波许超
浙江省丽水市人民医院,浙江 丽水 323000
Author(s):
WU BoJI WeipingWANG BoXU Chao
The People's Hospital of Lishui City,Lishui 323000,Zhejiang,China
关键词:
肱骨骨折 骨折固定术 儿童
Keywords:
Key words humeral fractures fracture fixationinternal child
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。
Abstract:
ABSTRACT 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.

参考文献/References:

[1] BEATY JH.Elbow fractures in children and adolescents[J].Instr Course Lect,2003,52:661-665.
[2] 安永刚,乔文海,邹海军,等.闭合复位克氏针交叉内固定治疗儿童肱骨髁上骨折[J].创伤外科杂志,2013,15(1):4.
[3] GARG S,WELLER A,LARSON AN,et al.Clinical characteristics of severe supracondylar humerus fractures in children[J].J Pediatr Orthop,2014,34(1):34-39.
[4] 何文,郑明,冯尔宥,等.闭合复位经皮克氏针内固定术与切开复位克氏针内固定术治疗儿童GartlandⅡ、Ⅲ型肱骨髁上骨折的疗效及安全性系统评价[J].中医正骨,2017,29(4):23-30.
[5] 蒋健,杨晓.尺侧小切口复位结合经皮交叉克氏针内固定治疗儿童肱骨髁上骨折[J].中医正骨,2015,27(2):60-61.
[6] GARTLAND JJ.Management of supracondylar fractures of the humerus in children[J].Surg Gynecol Obstet,1959,109(2):145-154.
[7] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:154.
[8] HOUSHIAN S,MEHDI B,LARSEN MS.The epidemiology of elbow fracture in children: analysis of 355 fractures,with special reference to supracondylar humerus fractures[J].J Orthop Sci,2001,6(4):312-315.
[9] CANALE ST,BEATY JH.坎贝尔骨科手术学[M].12版.王岩,译.北京:人民军医出版社,2013:1301-1302.
[10] FLYNN JC,MATTHEWS JG,BENOIT RL.Blind pinning of displaced supracondylar fractures of the humerus in children.Sixteen years'experience with long-term follow-up[J].J Bone Joint Sug Am,1974,56(2):263-272.
[11] 王亦璁.骨与关节损伤[M].3版.北京:人民卫生出版社,2001:575-585.
[12] 黄灏.儿童肱骨髁上骨折临床治疗研究[J].现代诊断与治疗,2014,25(6):1387.
[13] 余希临,徐扬,沈先涛,等.儿童GartlandⅡ型肱骨髁上骨折的手术治疗[J].中国矫形外科杂志,2011,19(2):103-105.
[14] 蓝吉斌,邓洪辉,宿玉玺,等.可吸收棒固定治疗儿童肱骨内上髁骨折[J].中华创伤杂志,2014,30(8):786-789.
[15] 陈刚,吴农欣,廉凯,等.利用数字骨科技术进行术前规划对儿童Ⅱ型肱骨髁上骨折复位及进针顺序的影响[J].中国矫形外科杂志,2014,22(8):760-762.
[16] 陈坤壮,蔡立雄,张宏宁,等.手法整复经皮穿针治疗儿童GartlandⅢ型肱骨髁上骨折的病例对照研究[J].中国骨伤,2014,27(7):583-586.
[17] 吴伟平,李旭,史强,等.GartlandⅢ型儿童肱骨髁上骨折的微创治疗[J].南方医科大学学报,2014,34(9):1351-1354.
[18] WORATANARAT P,ANGSANUNTSUKH C,RATTANASIRI S,et al.Meta-analysis of pinning in supracondylar fracture of the humerus in children[J].J Orthop Trauma,2012,26(1):48-53.
[19] LEE BJ,LEE SR,KIM ST,et al.Radiographic outcomes after treatment of pediatric supracondylar humerus fractures using a treatment-based classification system[J].J Orthop Trauma,2011,25(1):18-25.
[20] 莫贤跃,吴东敏,蒋荣玉.有限切开克氏针内固定治疗手法复位失败的儿童肱骨髁上骨折[J].临床骨科杂志,2015,18(3):358-359.
[21] 张会勇,苏利国,冯文博,等.两种克氏针固定方法治疗儿童肱骨髁上骨折疗效对比[J].中国医学前沿杂志(电子版),2014,6(10):56-58.

相似文献/References:

[1]温超海,何忠,李永斌,等.闭合复位伽玛钉改良成锁定支架内固定治疗 老年股骨转子间骨折[J].中医正骨,2015,27(11):32.
[2]肖善富,张喜善,于凤珍.髌下小切口钢丝纽扣式内固定治疗胫骨髁间隆突骨折[J].中医正骨,2015,27(11):34.
[3]裘人华,胡培阳,裘天强,等.闭合复位外固定架固定治疗Colles骨折[J].中医正骨,2015,27(11):59.
[4]沈海,刘昕,彭玉兰,等.复位架牵引下手法复位经皮穿针内固定治疗 儿童肱骨髁上骨折的临床研究[J].中医正骨,2015,27(10):1.
 SHEN Hai,LIU Xin,PENG Yulan,et al.Clinical study on reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation for treatment of humeral supracondylar fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):1.
[5]葛波涌,王玉波,王明太,等.交锁髓内钉内固定治疗胫骨干骨折的临床研究[J].中医正骨,2015,27(10):8.
 GE Boyong,WANG Yubo,WANG Mingtai,et al.Clinical study on the internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):8.
[6]邓红敏,刘志诚.转子间斜行截骨结合股骨近端防旋髓内钉固定治疗 股骨近端骨折术后髋内翻畸形[J].中医正骨,2015,27(10):17.
[7]孙群周,阮成群,李光明,等.股骨近端防旋髓内钉内固定治疗 老年不稳定型股骨转子间骨折[J].中医正骨,2015,27(10):20.
[8]方策,倪新宇,王宏伟,等.迟氏正骨手法复位单臂外固定支架固定治疗 老年股骨转子间骨折[J].中医正骨,2015,27(10):22.
[9]全先辉,万春友,刘磊,等.Taylor空间支架外固定治疗胫腓骨开放性骨折[J].中医正骨,2015,27(10):30.
[10]茆军,张惠法,严培军,等.Ilizarov外固定支架结合克氏针固定治疗Pilon骨折[J].中医正骨,2015,27(10):32.
[11]朱峰,宋相建,吴蔚,等.手法复位经皮克氏针内固定治疗 儿童闭合性肱骨远端全骨骺分离[J].中医正骨,2015,27(11):51.
[12]钱平康,徐锋,孙斌峰,等.肱骨近端内锁定系统固定结合植骨治疗肱骨近端骨折[J].中医正骨,2015,27(09):36.
[13]余斌峰,王伟良,林锡鹏.加长型肱骨近端内固定锁定系统治疗肱骨干骨折 合并同侧肱骨近端骨折[J].中医正骨,2015,27(08):23.
[14]黄杨,王昌兴,邹阳.AO钛制弹性髓内钉内固定与切开复位钢板内固定治疗 小儿肱骨干中下段骨折的比较研究[J].中医正骨,2015,27(07):22.
 HUNAG Yang,WANG Changxing,ZOU Yang.A comparative study of AO titanium elastic stable intramedullary nail internal fixation versus open reduction plate osteosynthesis for the treatment of mid-distal humeral fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):22.
[15]王海敏,汤志刚,诸葛天瑜,等.桥接组合式内固定系统固定治疗肱骨远端骨折[J].中医正骨,2015,27(12):63.
[16]蒋健,杨晓.尺侧小切口复位结合经皮交叉克氏针内固定 治疗儿童肱骨髁上骨折[J].中医正骨,2015,27(02):60.
[17]彭玉兰,周英,王英.分步手法复位肘关节外翻位固定联合外用中药治疗 婴幼儿肱骨髁上骨折[J].中医正骨,2015,27(04):56.
[18]曹进,胡珊珊,郑华江,等.闭合复位弹性髓内钉内固定与切开复位锁定加压钢板 内固定治疗青少年肱骨干骨折的疗效比较[J].中医正骨,2015,27(01):9.
 CAO Jin,HU Shanshan,ZHENG Huajiang,et al.A clinical comparison of closed reduction and elastic stable intramedullary nail internal fixation versus open reduction and locking compression plate internal fixation for treatment of humeral shaft fractures in adolescents[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(12):9.
[19]李卫国,孙献武,谭训香,等.闭合复位内外固定结合中医康复治疗肱骨近端骨折的临床研究[J].中医正骨,2016,28(05):1.
 LI Weiguo,SUN Xianwu,TAN Xunxiang,et al.Clinical study on closed reduction and internal & external fixation combined with TCM rehabilitation in the treatment of proximal humeral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(12):1.
[20]张川,张作君,蔡鸿敏,等.带肘肌肌瓣尺骨鹰嘴不规则截骨入路和V形截骨入路治疗肱骨远端C3型骨折的对比研究[J].中医正骨,2017,29(12):26.
 ZHANG Chuan,ZHANG Zuojun,CAI Hongmin,et al.A retrospective trial of irregular osteotomy approach versus V-shape osteotomy approach in anconeus flap olecranon osteotomy for treatment of type C3 distal humeral fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(12):26.

更新日期/Last Update: 2018-05-02