儿童尺骨鹰嘴骨折治疗后疗效分析

发布时间：2019-03-26 10:17

【摘要】：目的：探讨手术应用张力带技术及保守应用石膏外固定治疗不同类型儿童尺骨鹰嘴骨折的疗效，以期为临床应用提供参考。方法：收集2012年3月—2013年10月山东中医药大学附属医院小儿骨科病房诊断为尺骨鹰嘴骨折23例。其中手术治疗16例，石膏外固定保守治疗7例。男性18例，女性5例，年龄3—15岁，平均9.4岁。左侧11例，右侧12例。骨折按照创伤机制分为：屈曲型12例，伸直型11例，剪切型0例。所有患者均采用影像学检查及软组织损伤情况评估，手术组确定手术时机，进行手术治疗，术中注意保护软组织，术后予以石膏外固定，4周拆除石膏后予以指导患者功能康复、中药熏洗及外抹、锻炼等措施预防并发症的发生；保守组根据患儿骨折愈合情况予以石膏外固定4—6周，拆除固定后采取积极措施恢复肘关节功能。随访患儿6-12个月，平均8个月。采用Weselely等治疗尺骨鹰嘴骨折的治疗评定标准进行疗效评估。结果：23例患儿骨折全部愈合，根据Weselely等治疗尺骨鹰嘴骨折的治疗评定标准：优18例，良4例，可1例。所有病例无感染，无骨折再移位，无骨筋膜室综合症，无内固定松动，，无骨折畸形愈合及骨折延迟愈合等。结论：尺骨鹰嘴骨折是儿童肘关节损伤中较少见的一种类型，采用张力带技术固定及石膏外固定是治疗儿童尺骨鹰嘴骨折的理想方案。选择合适的治疗方案，术中保护软组织及患儿早期功能锻炼可获得满意疗效。
[Abstract]:Aim: to investigate the therapeutic effect of tension band technique and conservative plaster external fixation in the treatment of olecranon fractures in children of different types in order to provide reference for clinical application. Methods: from March 2012 to October 2013, 23 cases of ulnar olecranon fracture were diagnosed in pediatric orthopaedics ward of affiliated Hospital of Shandong University of traditional Chinese Medicine. Among them, 16 cases were treated surgically and 7 cases were treated conservatively with plaster external fixation. There were 18 males and 5 females, aged 3-15 years (mean 9.4 years). There were 11 cases on the left side and 12 cases on the right side. Fractures were divided into flexor type (n = 12), extension type (n = 11) and shear type (n = 0). All the patients were examined by imaging and the soft tissue injury was evaluated. The operation group was used to determine the time of operation, to carry out surgical treatment, to pay attention to the protection of soft tissue during the operation, and to apply plaster external fixation after operation. 4 weeks after removing gypsum to guide the patients with functional rehabilitation, traditional Chinese medicine fumigation and washing, exercise and other measures to prevent the occurrence of complications; The conservative group was treated with plaster external fixation for 4 weeks according to the healing condition of the fracture. After removal of the fixation, positive measures were taken to restore the elbow joint function. All patients were followed up for 6 months and 12 months (mean 8 months). The curative effect was evaluated by Weselely and other criteria for treatment of olecranon fracture of ulna. Results: all the fractures were healed in 23 cases. According to the criteria of Weselely et al., 18 cases were excellent, 4 cases were good and 1 case was fair. No infection, no fracture displacement, no osteofascial compartment syndrome, no loosening of internal fixation, no malunion of fracture and delayed union of fracture were found in all cases. Conclusion: olecranon fracture of ulna is a rare type of elbow joint injury in children. Tension band technique and plaster external fixation are the ideal methods for the treatment of fracture of ulnar olecranon in children. Choosing proper treatment scheme, protecting soft tissue during operation and early functional exercise in children can obtain satisfactory curative effect.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R726.8

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