| 儿童肱骨髁上骨折保守治疗旋前或旋后固定后肘内翻畸形的病例对照研究 |
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投稿时间：2014-07-27
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| 期刊信息：《中国骨伤》2014年，第27卷，第11期，第904-907页 |
| DOI：10.3969/j.issn.1003-0034.2014.11.005 |
| 基金项目: |
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中文摘要:
目的: 通过回顾性分析比较手法复位后旋前或旋后位石膏固定的儿童肱骨髁上骨折肘内翻畸形发生情况,从而指导临床治疗.
方法: 收集2009年6月至2011年12月在我院急诊骨科行手法复位石膏固定的儿童肱骨髁上骨折病例,经筛选排除后共64例.按手法复位后固定位置不同分为两组：A组采用手法复位并旋前位石膏固定,B组采用手法复位并旋后位石膏固定.A组30例,男18 例,女12例;平均年龄(7.5±3.5) 岁;B组34例,男23 例,女11 例,平均年龄(7.0±2.6)岁.比较两组组间及组内的肘内翻发生率及提携角减小角度.
结果: A组出现13例肘内翻,B组出现16例,两组差异无统计学意义(χ2=0.089,P=0.765).A组提携角减小角度(8±4)°,B组提携角减小角度(9±5)°,两组差异无统计学意义(t=0.584,P=0.564).A组组内桡偏型与尺偏型的肘内翻发生率与提携角减小角度差异均有统计学意义(χ2=6.160,P=0.013;t=-2.409,P=0.035);B组组内桡偏型与尺偏型的肘内翻发生率与提携角减小角度差异均有统计学意义(χ2=5.120,P=0.024;t=-2.250,P=0.041).两组肘关节功能Flynn评价差异无统计学意义(P=0.822).
结论: 儿童肱骨髁上骨折旋前位固定和旋后位固定肘内翻发生率和提携角减小角度均无明显差异.而尺偏型儿童肱骨髁上骨折,旋前位固定有利于降低肘内翻率及其程度;桡偏型儿童肱骨髁上骨折,旋后位固定有利于降低肘内翻率及其程度. |
| 【关键词】肱骨骨折 肘关节 石膏,外科 儿童 病例对照研究 |
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| Case-control study on the occurrence of cubitus varus deformity after humeral supracondylar fractures treated with plaster fixation in pronated or supinated position in children |
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ABSTRACT
Objective: To retrospectively compare the occurrence of cubitus varus deformity after humeral supracondylar fractures treated with manipulative reduction and plaster fixation in pronated or supinated position in children,and to guide clinical treatment.
Methods: From June 2009 to December 2011,the medical data of 64 children with humeral supracondylar fractures treated by manipulative reduction and plaster fixation were reviewed. All the patients were divided into two groups:group A and group B. The 30 patients in group A were treated with manipulative reduction and plaster fixation in pronation,including 18 males and 12 females,with a mean age of(7.5±3.5) years old. The 34 patients in group B were treated with manipulative reduction and plaster fixation in supination,including 23 males and 11 females,with a mean age of(7.0±2.6) years old. The occurrence rates of cubitus varus and decreases of carrying angle were compared between two groups before and after treatment.
Results: There were 13 patients in group A and 16 patients in group B having cubitus varus,which had no statistical difference (χ2=0.089,P=0.765). The decrease of carrying angle were (8±4)° in group A and (9±5)° in group B,which had no statistical difference (t=0.584,P=0.564). Within group A,the occurrence rate of cubitus varus and the decrease of carrying angle between the radial deviation and the ulnar deviation had statistically significant difference (χ2=6.160,P=0.013;t=-2.409,P=0.035). Within group B,the occurrence rate of cubitus varus and the decrease of carrying angle between the radial deviation and the ulnar deviation had statistically significant difference(χ2=5.120,P=0.024;t=-2.250,P=0.041). The elbow function Flynn evaluation score had no significant difference between two groups(P=0.822).
Conclusion: The occurrence rate of cybutys varys and the decrease of carrying angle have no obvious difference in children with humeral supracondylar fractures treated with fixation in pronated or supinated position. However,when treating with pediatrics humerus supracondylar fractures with ulnar deviation,the fixation in pronation is more helpful for reducing the occurrence rate of elbow varus and decrease of carrying angle. When treating with the pediatrics humerus supracondylar fractures with radial deviation,fixation in supination is helpful for reducing the occurrence rate of elbow varus and decrease of carrying angle. |
| KEY WORDS Humeral fractures Elbow joint Casts,surgical Child Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 卢敏,陈益,陈伟.儿童肱骨髁上骨折保守治疗旋前或旋后固定后肘内翻畸形的病例对照研究[J].中国骨伤,2014,27(11):904~907 |
| 英文格式: | LU Min,CHEN Yi,CHEN Wei.Case-control study on the occurrence of cubitus varus deformity after humeral supracondylar fractures treated with plaster fixation in pronated or supinated position in children[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(11):904~907 |
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