伸肘外翻位固定治疗儿童肱骨髁上伸直型骨折的临床研究

目的评价伸肘外翻位石膏固定治疗肱骨髁上伸直型骨折，预防肘内翻的临床疗效。方法收集2002～2005年漳州市中医院门诊及住院患者60例，年龄14岁以下，经临床及X线检查明确诊断为肱骨髁上伸直型骨折者，按就诊顺序及治疗方法不同，分为伸肘外翻位石膏固定组（简称治疗组）、屈肘位小夹板固定组（简称对照组），每组各30例，对各组病例肘内翻发生率、关节功能、B角及C角等方面进行比较，以评价伸肘外翻位石膏固定方法治疗肱骨髁上伸直型骨折，预防肘内翻的临床疗效。结果经过6～51个月随访，治疗组肘内翻发生率13．3％，对照组36．7％，经t检验。治疗组与对照组之间差异有统计学意义（P〈0．05）；治疗组、对照组在随访时B角、C角差异有统计学意义（P〈0．05）；而两组对骨折愈合后远期肘关节功能的影响差异无统计学意义（P〉0．05）。结论伸肘外翻位石膏固定治疗肱骨髁上伸直型骨折，能有效地预防肘内翻畸形的发生，降低肘内翻发生率。

Clinical studies on casts splint fixation in elbow extension in treating supracondylar extension-type fracture of humerus in children

Objective To evaluate the efficacy of reduction and casts splint fixation in elbow extension in treating supracondylar extension-type fracture of humerus in children and preventing the occurrence of cubitus varus.Methods Collected 60 patients under 14 who were diagnosed by clinic and X-ray to be supracondylar extension-type fracture of humerus and treated in the traditional Chinese medicine hospital of Zhangzhou Fujian from 2002-2005.According to the following up order and the treated method,the cases were divided into two groups:30 cases in the group of small splint fixation in elbow flexion,and 30 cases in the other group of casts splint in elbow extension.Compared each group on the rate of occurrence of cubitus varus,joint function,angle B and angle C,etc,to evaluate the efficacy of reduction and castsr splint fixation in elbow extension in treating supracondylar extension-type fracture of humerus in children and preventing the occurrence of cubitus varus.Results All cases had a mean follow-up of 6-51 months,and the rate of occurrence of cubitus varus of the casts splint group and the small splints contrast group group is 13.3%and 36.7%.Via T-test,there is significant difference between the 2 group in the rate of occurrence of cubitus varus(P<0.05)and the B angle,C angle during the follow-up(P<0.05),while there is no significant difference in the influence of the elbow joint function(P>0.05).Conclusion Reduction and casts splint fixation in elbow extension has an active effect in treating supracondylar extension-type fracture of humerus in children,preventing the occurrence of cubitus varus,and reduces the rate of occurrence of cubitus varus at a maximum.