桡骨小头半脱位的临床治疗分析

目的：探讨桡骨小头半脱位的临床相关因素及治疗效果。方法：回顾性分析68例桡骨小头半脱位患儿的发病年龄、发病因素及治疗效果。结果：68例桡骨小头半脱位患儿中,男25例,女43例。发病年龄：8个月～3岁38例（55.9%）,4～6岁25例（36.8%）,7～10岁5例（7.3%）。外伤至就诊时间：0.5～24h患儿60例（88.2%）,24～48h患儿8例（11.8%）。脱位原因：牵拉伤48例（70.6%）,患儿睡觉转身时患肢挤压伤12例（17.6%）,外伤8例（11.8%）。60例（88.2%）就诊时一次性复位成功,8例（11.8%）复位成功后再脱位,均为外伤至就诊时间超过24h患儿,经再次复位后患肢用三角巾悬吊胸前外固定制动7～10d后痊愈,无1例再发生脱位。结论：桡骨小头半脱位多见于5岁以下患儿,尤其是3岁以下患儿多见（本组占55.9%）。早期进行及时诊断及治疗能收到满意的治疗效果,受伤至就诊时间超过24h者复位后易于复发,复位后需进行短期制动才会收到好的治疗效果。

Clinical analysis on the treatment of radial head subluxation

Objective：To study the etiology and treatment outcome of radial head subluxation. Methods： The clinical data of 68 children with radial head subluxation in our hospital from February 2006 to December 2009 were analyzed retrospectively. Results： Sixty eight cases of children in outpatients included 25 boys and 43 girls, in which 38（55.9%） cases were 8 months to 3 years old, 25（36.8%） cases were 4 to 6 years old, and 5（7.3%） cases were 7 to 10 years old. Time of visiting hospital： 60（88.2%） cases were 30 min to 24 h, 8（11.8%） cases were 24～48 h. Etiology： 48（70.6%） cases were stretch injury, 12（17.6%） cases were crush injury during sleeping, and 8（11.8%） cases were trauma. Sixty of the 68 patients with radial head subluxation were cured by manual reduction and no recurrence was found, while 8 cases recurred were cured by manual reduction again and immobilized by triangle bandage for 7～10 d. The time of visiting hospital of these 8 patients were all more than 24 h. Conclusion： Radial head subluxation were mainly seen in children under 5 years old, especially less than 3 years old. Satisfactory treatment results can be reached by early diagnosis and therapy. Patients whose time of visiting hospital were more than 24 hours are easy to relapse, and short term immobilization after manual reduction is necessary to reach better outcome.