摘要
目的比较早期与延迟手术治疗儿童GartlandⅢ型肱骨髁上骨折的疗效。方法对2001年1月至2007年6月收治的86例闭合性、无血管神经损伤的GartlandⅢ型肱骨髁上骨折患儿资料进行回顾性分析，根据受伤至手术时间分为早期手术组（〈8h）和延迟手术组（〉8h），其中34例早期手术（伤后平均7．2h手术），52例延迟手术（伤后平均49．5h手术）。对两组患儿开放复位率、手术时间、医源性神经损伤发生率、针道与切口感染率、骨折愈合时间及肘关节功能恢复情况进行比较。结果早期手术组和延期手术组在开放复位率、手术时间、医源性尺神经损伤发生率、针道与切口感染率、骨折愈合时间及肘关节功能恢复情况等方面差异均无统计学意义（P〉0．05）。结论早期手术和延期手术对儿童GartlandⅢ型肱骨髁上骨折的疗效无明显影响，因此临床上应尽量在术前准备充分、患肘肿胀相对消退时进行手术。
Objective To compare the clinical results between early and delayed surgical treatments for completely displaced supracondylar humeral fractures in children. Methods Between January 2001 to June 2007, 86 children were treated at our department for completely displaced supracondylar humeral fractures without neurovascular injury. They were included in our retrospective investigation. Of them, 34 received early surgical treatment （within 8 hours after injury） and 52 had delayed surgical treatment （beyond 8 hours after injury）. Their general clinic data, quality of open reduction and internal fixation, perioperative and postoperative complications, iatrogenic nerve injury, healing time, and functional recovery of the elbow were all statistically compared between the 2 groups. Results There were no significant differences between the 2 groups in the quality of open reduction and internal fixation （ P =0. 746）, operation time（ P 〉 0.05）, iatrogenic nerve injury （ P = 0. 394）, pin-track infection （ P = 0. 631 ）, and functional recovcry of the elbow. No Volkmann ischemic contraetures occurred in either group. Conclusion Since no significant differences can be identified between the early and delayed surgery for the displaced supracondylar humeral fractures, the appropriate timing of surgical intervention can be decided by the surgeon.
出处
《中华创伤骨科杂志》
CAS
CSCD
2009年第8期714-717,共4页
Chinese Journal of Orthopaedic Trauma
基金
江苏省科教兴卫重点医学人才基金资助（RC2007087）
关键词
肱骨
骨折
肘关节
治疗结果
手术时机
Humerus
Fracture
Elbow joint
Treatment outcome
Timing of surgical intervention
