摘要
目的探讨GartlandⅢ型肱骨髁上骨折后8 h内急诊简单复位骨折对于手术的影响。方法回顾性分析2010年1月至2013年5月间由本院收治的120例GartlandⅢ型肱骨髁上骨折患儿临床资料,均为伸直型,依据手术方式分为:闭合复位经皮克氏针内固定组(A组),切开复位克氏针内固定组(B组)。分析两组患儿是否在骨折后8 h内进行简单骨折复位处理的骨折闭合率和手术时间。结果骨折后8 h内急诊简单复位骨折的患者共70例,其中采用闭合复位经皮克氏针内固定术者66例,平均手术耗时(30.83±3.16)min,因闭合复位失败而选择切开复位克氏针内固定术者4例,平均手术耗时(45.00±1.83)min;8 h内未简单复位骨折的患者共50例,其中采用闭合复位经皮克氏针内固定术者24例,平均手术时耗时(39.92±2.70)min,因闭合复位失败而选择切开复位克氏针内固定术者26例,平均手术时耗时(60.12±3.14)min;骨折8 h内早期简单复位者的闭合复位手术成功率较骨折后未早期简单复位者显著提高(P<0.05),无论采取何种术式,骨折8 h内早期简单复位均可显著缩短手术耗时(P<0.05)。即骨折8 h内早期简单复位可显著提高闭合复位克氏针内固定术的成功率,且缩短手术所耗时间;无论术式采用切开复位或者闭合复位,患者预后肘关节功能比较,差异无统计学意义(χ~2=2.460,P=0.483),肘关节功能恢复均较满意。结论小儿GartlandⅢ型肱骨髁上骨折后8 h内给予骨折简单复位,闭合复位手术成功率显著提高,是降低切开复位术式的有效措施之一;无论采取何种术式,8 h内早期进行简单骨折复位均可显著缩短手术耗时。
ObjectiveTo explore the effect of simple reduction of emergency fracture on the operation of GartlandⅢtype supracondylar humeral fracture within8hours MethodsRetrospective analysis was performed for120cases of Gartland typeⅢsupracondylar humeral fracture from January2010to May2013According to surgical approaches,they were divided into closed reduction of Kirschner wire fixation group(group A)and Kirschner wire fixation group(group B)Fracture closure rate and operative duration of two groups were analyzed for simple fracture reduction within8hours after fracture ResultsA total of70patients underwent simple reduction within8hours after fracture And closed reduction and percutaneous Kirschner wire fixation was performed in66patients The average operative duration was3083±316min There were4cases of internal fixation and the average operative duration was4500±183min A total of50patients underwent simple reduction of fractures beyond8hours while24patients had closed reduction and percutaneous Kirschner wire fixation The average operative duration was3992±270min Because of failed closed reduction,open reduction with wire fixation was peformed in26cases The average operative duration was6012±314min The success rate of closed reduction within8hours of early simple reduction was significantly higher than that of simple reduction after early fracture(P<005)No matter what type of procedure was used,simple reduction of early8hours of fracture could significantly shorten operative duration(P<005)Early reduction within8hours of fracture could significantly improve the success rate of closed reduction with Kirschner wire fixation and shorten operative duration;regardless of open reduction or closed reduction,patients with elbow function comparison(χ2=2460,P=0483),recovery of elbow function were satisfactory Conclusion Pediatric Gartland typeⅢsupracondylar humeral fracture may achieve simple reduction of fractures The success rate of closed resuscitation surgery is943%No matter what kind of surgery,8hours early Simple fracture reduction can significantly reduce operative duration
作者
赵景新
张志天
马亚昌
于涛
王瑜
Zhao Jingxin;Zhang Zhitian;Ma Yachang;Yu Tao;Wang Yu(Affiliated Hospital,Chengde Medical College,Chengde 067000,China;Chengde County Sangou Center Health Center,Chengde 067000,China)
出处
《临床小儿外科杂志》
CAS
2017年第4期381-385,共5页
Journal of Clinical Pediatric Surgery
基金
承德市科技局项目(编号:201601A051)
关键词
肱骨骨折
急诊处理
外科手术
治疗结果
儿童
Humeral Fractures
Emergency Treatment
Surgical Procedures,Operative
Treatment Outcome
Child
