Zhao Chao-Feng, Gao Quan-Yang, Zhang Tian-Jian, Han Lu-Li, Zhao Jun-Feng, Chen Gang, Cui Yu
Department of Orthopaedics, Luoyang Orthopedic Hospital of Henan Province, Luoyang 471002, Henan, China;
Department of Orthopaedics, Luoyang Orthopedic Hospital of Henan Province, Luoyang 471002, Henan, China.
Zhongguo Gu Shang. 2017 Jul 25;30(7):622-626. doi: 10.3969/j.issn.1003-0034.2017.07.008.
To explore the clinical effect of closed reduction and minimally invasive treatment of humeral shaft fractures in children.
From July 2011 to April 2015, 39 cases of pediatric humeral shaft fractures were treated by closed reduction and external fixation, including 27 males and 12 females with a mean age of 8.6 years old ranging from 3 to 14 years old. Time from injury to the treatment was 2 h to 7 days with an average of 2.7 days. There were 6 cases of upper fracture, 21 cases of middle fracture and 12 cases of lower fracture. All children were closed injury, appeared pain, swelling, local deformity and limited mobility and other symptoms after injury. X-ray examination showed humeral shaft fracture. Neer score of shoulder joint function and HSS score of elbow joint function were used to record and analyze the pain, function and activity of shoulder and elbow joint before and after treatment.
All the 39 cases were followed up for 6 to 12 months with a mean of 8.6 months. Two cases appeared postoperative superficial infection of the needle, and healed after dress; other cases gained good pinhole healing. There were significant differences in the pain, function and activity of the shoulder of Neer score before and after the treatment (<0.05). There were significant differences in the pain and function of the elbow of HSS before and after treatment (<0.05). According to the evaluation of Neer score of shoulder function, the total score was 88.82±2.50, 29 cases were excellent, 9 cases were good, and 1 case was fair. According to the evaluation of HSS score of elbow joint function evaluation, the total score was 91.51±5.09, 30 cases were excellent, 7 cases were good, 2 cases were general.
Manual closed reduction combined with external fixation for the treatment of humeral shaft fractures in children has advantages of less trauma, definite reduction effect, reliable fixation and benefit for early functional exercise of the shoulder and elbow joint. This therapy can be used as one of clinical methods for the treatment of humeral shaft fractures in children.
探讨儿童肱骨干骨折闭合复位及微创治疗的临床效果。
2011年7月至2015年4月，对39例儿童肱骨干骨折采用闭合复位及外固定治疗，其中男27例，女12例，平均年龄8.6岁，年龄范围3～14岁。受伤至治疗时间为2小时至7天，平均2.7天。骨折位于肱骨上段6例，中段21例，下段12例。所有患儿均为闭合伤，伤后出现疼痛、肿胀、局部畸形及活动受限等症状。X线检查显示肱骨干骨折。采用Neer肩关节功能评分和HSS肘关节功能评分记录并分析治疗前后肩、肘关节的疼痛、功能及活动情况。
39例均获随访6～12个月，平均8.6个月。2例术后出现针道浅表感染，经换药后愈合；其余病例针道愈合良好。治疗前后Neer评分中肩关节的疼痛、功能及活动情况差异有统计学意义（<0.05）。治疗前后HSS评分中肘关节的疼痛及功能差异有统计学意义（<0.05）。根据Neer肩关节功能评分评估，总分88.82±2.50，优29例，良9例，可1例。根据HSS肘关节功能评分评估，总分91.51±5.09，优30例，良7例，一般2例。
手法闭合复位联合外固定治疗儿童肱骨干骨折具有创伤小、复位效果确切、固定可靠、有利于肩肘关节早期功能锻炼等优点。该疗法可作为儿童肱骨干骨折的临床治疗方法之一。
