Jiang hai,Wang bin,Wu yongtao,et al.The operative treatment in children’s distal humeral osteoepiphysis fracture.[J].Journal of Clinical Pediatric Surgery,2010,9(02):0.
儿童肱骨远端骨骺分离的手术治疗
- Title:
- The operative treatment in children’s distal humeral osteoepiphysis fracture.
- Keywords:
- children; distal humeral osteoepiphysis fracture; operation
- 摘要:
- 目的 探讨手术治疗儿童肱骨远端骨骺分离的疗效。方法 自2002年1月至2006年8月，本院共收治12例肱骨远端骨骺分离的患儿，按Salter-Harris分型：Ⅰ型7例，Ⅱ型5例。合并桡神经损伤1例。9例采用肘关节外侧入路，3例采用肘关节后侧入路，行切开复位克氏针内固定治疗。术后拍片复查，3 ～ 6周拔除克氏针进行功能锻炼。 结果 本组12例，随访1 ～ 6年，平均36个月，骨折愈合时间3 ～ 6周，平均4周；9例患肘屈伸活动良好，2例患肘屈曲受限，1例发生肘内翻。1例桡神经损伤神经功能完全恢复。 结论 儿童肱骨远端骺分离复位困难，行手术切开复位内固定治疗，可以解剖复位，减少肘内翻的发生。外侧入路对肘关节功能影响小，术后功能恢复良好。
- Abstract:
- Objective To investigate the value of operative treatment in children’s distal humeral osteoepiphysis fracture. Methods From January 2002 to August 2006 ,12 cases were treated by operation. According to Salter-Harris system, there were 7 typeⅠfracture,5 typeⅡfracture. There was 1 case combined with injury of musculospiral nerve. 9 cases were operated by elbow joint outboard approach and 3cases by posterior approach. They were fixed with Kirschner wire after open reduction. Immediate postoperative radiographs were closely analyzed to determine reduction accuracy. The x-ray counterchecks were made after operation. The Kirschner wire was removed after 6weeks and exercises were done immediately . Results All patieats were followed up for 1 to 6 years after injury, 3 years in average. The time of healing of fracture was from 3weeks to 6 weeks, 4 weeks in average. 9 patients had good function of elbow. 2 cases had decrement of flection. 1 case had elbow varus deformity. The nerve function was recovered totally after operation. Conclusions It is difficult to get an anatomical contraposition by closed reduction. The operation can get an anatomical contraposition and decrease the deformity. The outboard approach is recommend.
参考文献/References:
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典型病例
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备注/Memo
西安市红十字会医院儿骨科（陕西省，710054）