[1]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):1-4.
　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(10):1-4.
点击复制

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()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年10期
页码:
1-4
栏目:
临床研究
出版日期:
2015-10-30

文章信息/Info

Title:
Clinical study on reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation for treatment of humeral supracondylar fractures in children
作者:
沈海; 刘昕; 彭玉兰; 乐劲涛; 王英; 周英; 邓志强
四川省骨科医院,四川 成都 610041
Author(s):
SHEN Hai; LIU Xin; PENG Yulan; YUE Jintao; WANG Ying; ZHOU Ying; DENG Zhiqiang
Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China
关键词:
肱骨骨折;  正骨手法;  牵引术;  治疗; 临床研究性
Keywords:
humeral fractures;  bone setting manipulation;  traction;  therapies; investigational
摘要:
目的:观察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疗效。方法:将符合要求的60例肱骨髁上骨折患者随机分为复位架组和手法复位组,每组30例。复位架组采用复位架牵引下手法复位经皮穿针内固定治疗,手法复位组采用手法复位经皮穿针内固定治疗。比较2组患者的手术时间、住院时间、肘内翻发生率及临床疗效。临床疗效评价采用《中医病证诊断疗效标准》中肱骨髁上骨折的疗效标准。结果:复位架组的手术时间和住院时间均比手法复位组短[(33.73±10.33)min,(40.55±9.44)min,t=9.223,P=0.000;(13.95±2.96)d,(17.75±4.10)d,t=1.425,P=0.037]。术后6周时共有3例患者失访(复位架组1例、手法复位组2例),复位架组9例发生肘内翻、手法复位组15例发生肘内翻,2组患者肘内翻的发生率比较,差异无统计学意义(χ2=2.968,P=0.085); 复位架组治愈20例、好转9例,手法复位组治愈13例、好转15例,2组患者的临床疗效比较,差异无统计学意义(Z=-1.708,P=0.088)。结论:复位架牵引下手法复位经皮穿针内固定术治疗儿童肱骨髁上骨折疗效确切,并可有效缩短手术时间及住院时间,值得临床推广应用。
Abstract:
Objective:To observe the clinical curative effect of reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation in the treatment of humeral supracondylar fractures in children.Methods:Sixty patients with humeral supracondylar fractures enrolled in the study were randomly divided into reduction frame group and manipulative reduction group,30 cases in each group.The patients in reduction frame group were treated with reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation,while the others in manipulative reduction group were treated with manipulative reduction combined with percutaneous Kirschner wire internal fixation.The operative time,hospital stay,incidence rate of cubitus varus and clinical effects were compared between the 2 groups,and the curative effects were evaluated according to the therapeutic effect criterion of humeral supracondylar fracture which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Results:The operative time and hospital stay of reduction were shorter in reduction frame group compared to manipulative reduction group(33.73+/-10.33 vs 40.55+/-9.44 min,t=9.223,P=0.000; 13.95+/-2.96 vs 17.75+/-4.10 days,t=1.425,P=0.037).One patient in reduction frame group and 2 patients in manipulative reduction group lost to follow-up 6 weeks after the operation,and cubitus varus were found in reduction frame group(9 cases)and manipulative reduction group(15 cases).There was no statistical difference in the incidence rate of cubitus varus between the 2 groups(χ2=2.968,P=0.085).Twenty patients obtained an excellent result and 9 good in the reduction frame group,while 13 patients obtained an excellent result and 15 good in the manipulative reduction group,and there was no statistical difference in the clinical curative effect between the 2 groups(Z=-1.708,P=0.088).Conclusion:The clinical curative effect of reduction frame traction combined with manipulative reduction and percutaneous Kirschner wire internal fixation is definite for treatment of humeral supracondylar fractures in children,and the operative time and hospital stay can be shortened effectivity,so it is worthy of popularizing in clinic.

参考文献/References:

[1] 陆裕朴,胥少汀,葛宝丰,等.实用骨科学[M].北京:人民军医出版社,1991:582-585.
[2] 国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:164.
[3] 秦海辉,禚保彪,史迎春,等.儿童伸直型髁上骨折发生肘内翻的原因分析[J].徐州医学院学报,2014,34(3):186-188.
[4] 王英,沈海,乐劲涛,等.儿童上肢牵引复位固定器结合夹板治疗肱骨髁上骨折的疗效观察[J].中国中医骨伤科杂志,2011,19(1):9-10.
[5] 康宇翔.儿童肱骨髁上骨折诊断与治疗进展[J].中国矫形外科杂志,2013,21(14):1410-1415.
[6] 浦立勇,张锡庆,王晓东,等.肱骨髁上骨折并发肘内翻的生物力学研究[J].中华小儿外科杂志,2002,23(3):237-239.
[7] 刘贤炳,王胜利.肱骨髁上部位应力场分布的有限元分析[J].中国中医骨伤科杂志,1993,1(3):9-11.
[8] 张问广,胡月光.肱骨髁上骨折并发肘内翻的临床与应用解剖研究[J].临床小儿外科杂志,2008,7(3):43-44.
[9] 何本祥,檀亚军,黎万友,等.郑氏手法复位小夹板和塑形托板双重外固定治疗移位性肱骨髁上骨折[J].中医正骨,2013,25(12):74-76.
[10] 陈贵全,陈越,赵明东,等.儿童伸直尺偏型肱骨髁上骨折防治分析[J].中医正骨,2009,21(4):58-59.
[11] 吴立功,杨世斌.闭合复位治疗儿童GartlandⅡ型和Ⅲ型肱骨髁上骨折[J].中国骨伤,2013,26(2):98-101.
[12] 乐国平,张明.儿童肱骨髁上骨折治疗方法与预后结构及功能重建的关系[J].中国组织工程研究与临床康复,2008,12(7):1209-1212.
[13] 王强,李文锋,宋宝健,等.闭合复位、经皮桡侧交叉克氏针固定治疗儿童Ⅲ型肱骨髁上骨折[J].中华小儿外科杂志,2008,29(11):682-684.
[14] 谢德东,汪金平,杨小奇,等.闭合复位结合不同方式经皮克氏针固定治疗儿童肱骨髁上骨折[J].中国骨与关节损伤杂志,2007,22(4):330-332.
[15] 王浩然,仲肇平,陈秋.GartlandⅢ型儿童肱骨髁上骨折治疗方式探讨[J].中国中医骨伤科杂志,2014,22(6):29-31.

相似文献/References:

[1]张容超,徐卫国,万春友,等.手法整复小夹板固定治疗桡骨远端骨折168例[J].中医正骨,2015,27(11):61.
[2]王 强.胫腓下联合骨牵引配合手法整复小夹板外固定治疗 儿童闭合移位性股骨干骨折[J].中医正骨,2015,27(10):15.
[3]伍辉国,江克罗,张文正,等.手法复位杉树皮小夹板固定治疗儿童闭合性指骨骨折[J].中医正骨,2015,27(10):63.
[4]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.
[5]姜自伟,欧阳崇志,黄枫,等.肱骨近端骨折改良Neer分型的四部评分法[J].中医正骨,2015,27(09):64.
[6]袁荣霞,董霞,赵纯,等.改良折顶手法复位小夹板固定治疗儿童尺桡骨远端双骨折[J].中医正骨,2015,27(08):18.
[7]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.
[8]刘震,胡志国,付伟.抖牵旋按复位结合钢针撬拨复位空心钉内固定治疗 难复性股骨颈骨折[J].中医正骨,2015,27(08):28.
[9]郭振平,李占国,刘一,等.陈氏正骨手法治疗肩关节脱位的优势及特色[J].中医正骨,2015,27(08):67.
[10]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(10):22.
[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]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.
[13]何影浩.手法复位小夹板固定治疗儿童肱骨干远端骨折合并肱骨髁上骨折[J].中医正骨,2016,28(05):48.
[14]曹谦,曹慎,杨韵琴.GartlandⅢ型肱骨髁上骨折手法复位小夹板外固定治疗后残存单纯前后移位对预后的影响[J].中医正骨,2017,29(09):7.
　CAO Qian,CAO Shen,YANG Yunqin.Effect of posttreatment residual simple anterior-posterior displacement of broken end of fractured bone on prognosis in patients who receive manipulative reduction and small splint external fixation for Gartland typeⅢhumeral supracondylar fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(10):7.
[15]王广伟,霍力为,贺华勇,等.手法复位小夹板外固定配合垂直悬吊治疗肱骨干中上段不稳定骨折[J].中医正骨,2019,31(03):63.
[16]陈元荣,江湧,邓蕴源,等.手法复位小夹板固定治疗肱骨干中下段粉碎性骨折[J].中医正骨,2019,31(03):66.
[17]郑晓蓉,萧庆瑞,王振盛,等.手法复位石膏托固定治疗肱骨小头骨折[J].中医正骨,2020,32(11):55.
[18]张元斌,张玉良,罗程,等.张氏骨伤正骨手法复位定制杉树皮夹板联合塑形铝板外固定治疗儿童伸直型肱骨髁上骨折[J].中医正骨,2021,33(12):51.
[19]刘栋,曹谦,曹慎,等.杨氏三步复位法复位杉树皮夹板固定治疗肱骨干骨折[J].中医正骨,2024,36(06):75.

备注/Memo

备注/Memo:
2015-07-22收稿 2015-08-31修回
基金项目:四川省中医药管理局科研基金资助项目(2011SZ0251)
通讯作者:沈海 E-mail:2430967067@qq.com
更新日期/Last Update: 2015-10-30