摘要
目的比较闭合和切开复位联合克氏针内固定治疗儿童GartlandⅢ型肱骨髁上骨折的临床效果。方法回顾性分析2016年5月-2017年5月绵阳市中心医院小儿外科收治的101例GartlandⅢ型肱骨髁上骨折患儿的临床资料,其中男性72例,女性29例;年龄2~13岁,平均5.8岁。按手术方法不同分为切开组(n=51,采用切开复位联合克氏针内固定治疗)和闭合组(n=50,采用闭合复位联合克氏针内固定治疗),比较两组手术效果、临床相关指标、术后3、6个月测量Baumann角和提携角及术后并发症情况。结果末次随访时两组优良率(88.2%vs.94.0%)比较差异无统计学意义(χ~2=1.031,P=0.309);闭合组术中失血量(2.0±0.9)m L、手术时间(23.0±3.2)min、住院时间(7.5±1.6)d及骨折愈合时间(5.2±1.1)个月均少(短)于切开组[(12.1±1.2)m L、(35.8±4.0)min、(12.4±2.5)d、(8.9±2.8)个月,t=48.253、17.871、11.706、8.708,均P<0.001];术后3个月及术后6个月两组提携角[(12.5±2.5)°vs.(12.9±2.0)°、(12.5±2.3)°vs.(12.9±2.6)°]和Baumann角[(71.3±9.3)°vs.(72.6±12.2)°、(70.2±8.3)°vs.(71.8±10.2)°]比较,差异无统计学意义(t=0.455、0.614、0.603、0.865,P=0.650、0.541、0.548、0.389);经随访两组术后并发症发生率(2.0%vs.4.0%)比较差异无统计学意义(χ2=0.364,P=0.546)。结论儿童GartlandⅢ型肱骨髁上骨折采用闭合复位联合克氏针内固定与切开复位联合克氏针内固定治疗效果相当,但前者具有手术时间及住院时间短等特点,且创伤小、骨折愈合较快,对患儿皮肤美观无影响。
Objective To compare the clinical effect of closed and open reduction combined with Kirschner wire internal fixation in the treatment of Gartland typeⅢsupracondylar fracture of humerus in children.Methods The clinical data of 101 children with Gartland typeⅢsupracondylar fracture of humerus admitted to Department of Pediatric Surgery of Mianyang Central Hospital from May 2016 to May 2017 were analyzed retrospectively.There were 72 males and 29 females,with an average age of 5.8 years(range,2-13 years).They were divided into open group(n=51,treated by open reduction combined with Kirschner wire internal fixation)and closed group(n=50,treated by closed reduction combined with Kirschner wire internal fixation)according to different operation methods.The operation effect,clinical related indexes,Baumann angle and carrying angle at 3 and 6 months after operation and postoperative complications were compared between the two groups.Results At the final follow-up,there was no significant difference in the excellent and good rate(88.2%vs.94.0%)between the two groups(χ2=1.031,P=0.309).The intraoperative blood loss(2.0±0.9)m L,operation time(23.0±3.2)min,hospitalization time(7.5±1.6)d and fracture healing time(5.2±1.1)months in closed group were shorter than those in open group(12.1±1.2)m L,(35.7±3.9)min,(12.4±2.5)d,(8.9±2.8)months(t=48.253,17.871,11.706,8.708,all P<0.001).There was no significant difference in carrying angle[(12.9±2.5)°vs.(13.1±2.0)°,(12.5±2.3)°vs.(12.9±2.6)°]and Baumann angle[(71.3±9.3)°vs.(72.6±12.2)°,(70.2±8.3)°vs.(71.8±10.2)°]between the two groups at 3 and 6 months after operation(t=0.455,0.614,0.603,0.865,P=0.650,0.541,0.548,0.389).There was no significant difference in the incidence of postoperative complications(2.0%vs.4.0%)between the two groups after follow-up(χ2=0.364,P=0.546).Conclusion Closed reduction combined with Kirschner wire internal fixation and open reduction combined with Kirschner wire internal fixation for supracondylar fracture of humerus of Gartland typeⅢin children have the same therapeutic effect.However,closed reduction combined with Kirschner wire internal fixation has the characteristics of shorter operation time and hospitalization time,small or trauma and faster fracture healing,which has no effect on the skin beauty of children.
作者
杨健
唐青松
杨周健
宋鹏
蒲永斌
陈曹婧
刘钧
YANG Jian;TANG Qing-song;YANG Zhou-jian;SONG Peng;PU Yong-bin;CHEN Cao-jing;LIU Jun(Department of Pediatric Surgery,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)
出处
《创伤外科杂志》
2020年第5期354-358,共5页
Journal of Traumatic Surgery
基金
四川省卫生和计划生育委员会科研课题(160149)。
关键词
肱骨髁上骨折
GartlandⅢ型
闭合复位
克氏针
内固定
儿童
supracondylar fracture of humerus
Gartland typeⅢ
closed reduction
Kirschner wire
internal fixation
children
