儿童肱骨髁上骨折复位后的康复锻炼

目的探讨预防儿童肱骨髁上骨折后肘内翻的康复方法,以降低肘内翻的发生率。方法便利抽样法选取2008年2月至2010年12月在深圳市第七人民医院治疗的60例肱骨髁上骨折患儿为研究对象,按随机数字表法将其分为对照组与观察组,每组30例。对照组患儿采用传统的骨科术后常规康复锻炼方法,观察组患儿除常规功能锻炼外,根据桡侧嵌插、尺侧分离的原则进行肘外翻练习。比较两组患儿的骨折愈合时间及愈合效果,并在3个月随访时,比较两组患儿肘内翻的发生率。结果两组患儿的骨折愈合时间的差异无统计学意义(P>0.05)。观察组患儿肘关节功能及携带角变化的优良率为83.30%和90.00%,均优于对照组的80.00%和63.30%,差异均有统计学意义(均P<0.05)。经过3个月的随访,观察组患儿的肘内翻发生率为10.0%,低于对照组的36.7%,差异有统计学意义(P<0.05)。结论儿童肱骨髁上骨折康复中,应用肘外翻练习可以有效预防肘内翻的发生,且有助于患儿肘关节的功能恢复,对骨折愈合无不良影响,值得临床推广应用。

Rehabilitation Exercise after Supracondylar Fractures of Humerus in Children

Objective To discuss the rehabilitation methods in prevention of cubitus varus after supracon- dylar fracture of humerus in children,so as to reduce the incidence of cubitus varus. Methods From February 2008 to December 2010,60 children with supracondylar fractures in the hospital were randomized into observational group（n=30） and control group（n= 30）. All the children underwent orthopedic convention- al rehabilitation training methods. Then the children in the observational group received the additional cubitus valgus practice according to the principle of radial side of the intercalation the ulnar separation. Comparisons were conducted on the healing time and healing effect between the two groups. In the following 3-month follow-up, further comparisons were performed on the incidence of cubitus varus. Results There was no significant difference on the heeling time between the two groups（P〉0.05）. The excellent rates of elbow function and changes in carrying angles in （83.30% vs 90.00%） the observational group were significantly superior to those （80.00% vs 63.30%） in the control group（P~0.05）. The 3-month follow-up shown that the incidence of eubitus varus in the observational group was significantly lower than that in the control group（10.0% vs 36.7% ,P〈0. 05）. Conclusion During the rehabilitation of supracondylar fracture of humerus in children, cubitus valgus exercises has an effective role in preventing cubitus varus and has no adverse effects in the function and healing of fracture of elbow in children,which deserves further clinical application.