肱骨髁上骨折3种手术方法的疗效评价

目的：探讨3种手术方法治疗儿童肱骨髁上骨折的临床疗效。方法：肱骨髁上骨折103例，其中男58例，女45例；年龄3～12岁，平均7．4岁。根据手术入路分肘内侧切口（A组）37例，肘外侧切口（B组）35例及肘后侧切口（C组）31例．比较术后肘关节仲屈功能丢失和肘内翻发生情况。结果：随访18个月～8年，平均32个月。发生肘关节伸屈功能丢失：A组6例，B组6例，C组25例，C组的发生率明显高于A、B两组（P〈0．01）。发生肘内翻：A组8例，B组17例，C组7例，B组的发生率明显高于A、C两组（P〈0．05）。结论：3种手术入路治疗肱骨髁上骨折有不同疗效，肘外侧切口肘内翻发生率较高，肘后切口肘伸屈功能明显降低，肘内侧切口效果肯定。

Effects of supracondylar fractures of humerus treated by three different surgical methods

Objective: To research the effects of supracondylar fractures of humerus treated by three different surgical methods. Methods: There were 103 patients with supracondylar fractures of humerus including 58 male and 45 female. The age was from 3 to 12 years old with the average of 7.4 years. To divide the cases into three groups by the operative approach in the humerus,the inside approach were in 37 cases(group A),the outside in 35 cases(group B) and the rear in 31 cases(group C). Comparing the reduction of the stretching and bending function of elbow joint and incidence of elbow varus. Results: All patients were followed-up for 1.5 to 8 years after operation with the average of 32 months. The reduction of stretching and bending function of elbow joint occurrenced in 6 cases in group A,6 cases in group B and 25 cases in group C,the incidenc of group C were obvious more than group A and B(P<0.01). The elbow varus occurrenced in 8 cases in group A,17 cases in group B and 7 cases in group C,the incidence of group B were obviously more than group A and C(P<0.05). Conclusion: There are different effects between three kinds of operative approaches in the humerus. The incidence of outside group is higher on the varus of elbow. The incidence of rear group is higher on the ability of elbow joint stretching and bending. The effect of inside group is sure on the operative approach in the humerus.