摘要
目的：了解肱骨内上髁骨骺分离后不同术式疗效的差异及其多发项目、发生机制及对肱骨远端形态的影响。背景：目前对肱骨内上髁骨骺分离进行切开复位后的内固定方法很多，哪种较好有待比较；牵拉骨骺损伤后对局部骨形态的影响也有待进一步探讨。方法：（１）对１３例切开复位缝合固定的运动员和１４例切开复位双克氏针内固定的运动员的术后长期疗效进行比较。（２）对２７例运动员中的１４例进行肱骨远端形态的Ｘ线测量。结果：（１）切开复位、双克氏针内固定的１４例疗效均优，为１００％。１３例缝合固定者中，优７７％，良２３％。所以，以切开复位、双克氏针内固定疗效为较好。（２）运动员中，此病的多发项目依次是体操、举重和舞蹈。（３）损伤机制中，除倒地手支撑伤外，抓举的提铃、杠铃过顶负重展肩和负重深蹲起也可致伤；（４）术后肱骨内外上髁间距增大（Ｐ＜０．００１），肱骨滑车和肱骨纵轴间的内下夹角变小（Ｐ＜０．００１），内上髁高度下降（Ｐ＜０．０５），尺神经沟处出现切迹，携物角有增大趋势。（５）术后伸肘功能恢复要比屈肘功能恢复所用时间长（Ｐ＜０．０５），因此，应更重视伸肘功能的康复。
urpose: To evaluate the efffects of different surgical methods on epiphyseal separation of medial epicondyle of the humerus and an investigation of its vulnerable athletic sport events as well as the mechanism and its influence on the shape of the distal end of the humerus. Background: Different surgical methods are avaliable for the treatment of epiphyseal separation of the humeral epicondyle, however, one can not be sure about the best option for an individual case. Moreover, the influence of these procedures on the configuration of the distal end of the humerus has never been clearly described. Methods: (1)Following open reduction, 13 cases had suture fixation, 14 had internal fixation with double K wires. The longterm postoperation effects were studied in comparison. The followup period averaged for 8.84 years. (2)Xray measurements of the distal end of the humerus were done in 14 of the 27 athletes. Results: (1)All the 14 patients treated with double Kwire fixation obtained excellent results (100%). In the 13 cases treated with suture fixation, the results were excellent in 77% and good in 23%. (2)Gymnastics appeared to be the most vulnerable event, and then in the decending order of vulnerability, the weight lifting and dancing. (3) Besides hand strutting during a fall that could cause epiphyseal avulsion, bringing the barbell up, holding weight over head with extension of the shoulder joint and standing up from the squatting position during snatching are also the frequent events causing epiphyseal injury. (4) Xray measurements revealed an increase of the distance between medial and lateral epicondyle (P<0.001) and a lowered position of the medial epicondyle (P<0.001) than that before the injury. Also there was a decrease of the inferiormedial angle between the humeral middle axis and a decrease of the tilting of the trochlear joint surface (P<0.05). An incisura appeared in the ulnar nerve sulcus and there was a tendency of the increase of the carrying angle. (5) Rehabilitation of the extension function of the elbow needed much more emphasize than that of the flexion function.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第1期23-26,共4页
Chinese Journal of Orthopaedics
关键词
运动损伤
肱骨
骨骺脱离
肘功能
治疗
康复
thletic injuries Humerus Epiphyses
slipped Treatment outcome Bone development
