肘部肌力平衡方法治疗儿童肱骨髁上骨折

目的:通过肘伸直前臂旋后位固定方法以保持肘部肌力平衡,并探讨肘部肌力平衡在治疗儿童肱骨髁上骨折及防止肘内翻形成中的作用。方法:难复性儿童肱骨髁上骨折96例,男53例,女43例;年龄最大10岁,最小1岁,平均5.6岁。受伤至就诊时间1h¹0d。左侧46例,右侧50例。伸直型71例,屈曲型25例。采用手法力线复位,恢复与健侧相等的携带角,平衡肘部肌力,使肘部内外侧韧带的张力相等,采用肘伸直前臂旋后位固定方法治疗。结果:96例均获随访,随访时间3个月,肘关节功能均恢复,携带角与健侧相同者89例,携带角小于健侧1°³°者7例。依据中医骨伤科病症诊断疗效标准,96例均达到治愈,无肘内翻发生。结论:儿童肱骨髁上骨折,不强求良好的对位,应该强调力线复位、肌力平衡,采用肘伸直前臂旋后位固定方法治疗,能有效防止肘内翻畸形的发生。

Muscle strength balance of elbow in the treatment of humeral supracondylar fracture in children

Objective:To study the effects of muscle strength balance of elbow by using fixation method of elbow at straighten-supination position in the treatment of humeral supracondylar fracture in children and the prevention from cubitus varus.Methods:Among 96 patients with humeral supracondylar fracture,53 were male and 43 were female,ranging in age from 1 to 10 years(mean 5.6 years).The time spans from injury to treat- ment were 1 hour to 10 days.Forty-six patients had left fracture and 50 patients had right fracture.Seventy-one patients were fracture of straightened type and 25 patients were fracture of inflexion type.The fixation method of elbow at straighten-supination position was used in the treatment.Results:All the patients were followed up for 3 months.Elbow function recovered in all patients.Eighty-nine patients had normal carrying angle which was the same as uninjured side,and 7 patients had carrying angle less than that of uninjured side in 1 to 3 degree.According to disease diagnosis and treatment standard of Orthopaedics and trauma of TCM,all the patients had fracture healing without cubitus varus.Conclusion:In the treatment of humeral supracondylar fracture,the emphasis is not on excellent contraposition,but on correct alignment.Using fixation method of elbow at straighten-supination position to maintain its muscle strength balance is effective to prevent from cubitus varus in the treatment of humeral supracondylar fracture.