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肱骨髁上骨折的神经损伤发生率。

Prevalence of Nerve Injuries in Supracondylar Fracture of Humerus in a Tertiary Care Hospital.

机构信息

Department of Orthopaedics, Bharatpur Hospital, Chitwan, Nepal.

Department of Orthopaedics, National Trauma Center, Kathmandu, Nepal.

出版信息

J Nepal Health Res Counc. 2021 Sep 6;19(2):367-371. doi: 10.33314/jnhrc.v19i2.3637.

Abstract

BACKGROUND

Supracondylar fracture is a common childhood injury. These fractures are often associated with neural and vascular injuries. There is discrepancy in literature about the most common nerve injured in such fractures. This study aims to study the nerve injury patterns in supracondylar fractures of humerus in Nepalese children.

METHODS

This descriptive cross sectional study was conducted in 152 children (aged 2 to 14 years) with supracondylar fractures of humerus attending in Bharatpur Hospital during the period of one year. All eligible patients were assessed clinically and radiologically. Neurological assessment was done for nerve injury.

RESULTS

Out of 152 children, 18(11.8%) had nerve injuries. The mean age was 7.41±2.91 years. Boys were more injured (68.4%) than girls (31.6%). It was more common on non-dominant side (57.9%). Out of 18 nerve injuries, most commonly injured nerve was median nerve 10(55.5%) followed by radial nerve 7(38.9%). Median nerve injury was common in posterolateral displacement and radial nerve injury was common in posteromedial displacement type of fracture.   Conclusions: Displaced supracondylar fractures have relatively higher prevalence of nerve injuries. Most commonly involved nerve is median nerve followed by radial nerve. So, every displaced fracture should be routinely screened for nerve injuries.

摘要

背景

髁上骨折是一种常见的儿童损伤。这些骨折常伴有神经和血管损伤。文献中对于此类骨折中最常见的神经损伤存在差异。本研究旨在研究尼泊尔儿童肱骨髁上骨折的神经损伤模式。

方法

这是一项在 Bharatpur 医院进行的为期一年的 152 名肱骨髁上骨折儿童的描述性横断面研究。所有符合条件的患者均进行临床和影像学评估。对神经损伤进行神经评估。

结果

152 名儿童中,有 18 名(11.8%)有神经损伤。平均年龄为 7.41±2.91 岁。男孩(68.4%)比女孩(31.6%)受伤更多。非优势侧(57.9%)更常见。18 例神经损伤中,最常见的损伤神经是正中神经 10 例(55.5%),其次是桡神经 7 例(38.9%)。正中神经损伤常见于后外侧移位,桡神经损伤常见于后内侧移位型骨折。

结论

移位的髁上骨折神经损伤的发生率相对较高。最常见的受累神经是正中神经,其次是桡神经。因此,每个移位的骨折都应常规筛查神经损伤。

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