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[儿童肱骨髁上移位骨折的治疗(三种不同治疗方法的评估)]

[The treatment of displaced supracondylar fractures of the humerus in children (an evaluation of three different treatment methods)].

作者信息

Diri Bülent, Tomak Yilmaz, Karaismailoğlu Turgut Nedim

机构信息

Ondokuz Mayis Universitesi, Tip Fakultesi Ortopedi ve Travmatoloji Anabilim Dali, Samsun, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2003 Jan;9(1):62-9.

Abstract

BACKGROUND

Supracondylar fractures of the humerus are the most common fracture pattern of the elbow in childhood. They require close follow-up subsequent to successful treatment, because of having a great risk of many complications. Many treatment methods have been described for the treatment of displaced supracondylar fractures of the humerus, however it has not been reached a consensus for the choice of the treatment. The purpose of this study is to investigate the late results of three different treatment methods; closed reduction+cast immobilization, skeletal traction+cast immobilization and open reduction+internal fixation by K-wires. We also aimed to compare these methods with the results of current literature.

METHODS

Fifty-three (41 boys and 12 girls) displaced supracondylar humerus fractures were treated between January 1986 and March 1999. The average age was 8.0 years. We evaluated the results of patients according to Flynn's criterias.

RESULTS

According to the results of the study, we obtained 31 excellent, 9 good, 5 fair and 8 poor results. The ratio of poor results of closed reduction+cast immobilization, skeletal traction+cast immobilization and open reduction+internal fixation by K-wires were 28.6%, 14.3% and 12.8%, respectively.

CONCLUSION

The datas in our study show that closed reduction+cast immobilization results in the most poorest outcome in the treatment of displaced supracondylar humerus fractures.

摘要

背景

肱骨髁上骨折是儿童肘部最常见的骨折类型。由于存在多种并发症的巨大风险,成功治疗后需要密切随访。对于移位性肱骨髁上骨折的治疗,已经描述了许多治疗方法,然而在治疗选择上尚未达成共识。本研究的目的是调查三种不同治疗方法的后期结果;闭合复位+石膏固定、骨牵引+石膏固定和切开复位+克氏针内固定。我们还旨在将这些方法与当前文献的结果进行比较。

方法

1986年1月至1999年3月期间,对53例(41例男孩和12例女孩)移位性肱骨髁上骨折进行了治疗。平均年龄为8.0岁。我们根据弗林标准评估患者的结果。

结果

根据研究结果,我们获得了31例优、9例良、5例可和8例差的结果。闭合复位+石膏固定、骨牵引+石膏固定和切开复位+克氏针内固定的差结果比例分别为28.6%、14.3%和12.8%。

结论

我们研究中的数据表明,在移位性肱骨髁上骨折的治疗中,闭合复位+石膏固定导致的结果最差。

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