目的 总结儿童浮肘损伤的临床特点、治疗方法及疗效。
方法 回顾分析2008年1月-2013年12月收治的19例浮肘损伤患儿临床资料,男14例,女5例;年龄14个月~13岁7个月,平均8岁。肱骨髁上骨折均为Gartland Ⅲ型。开放骨折1例,合并血管损伤1例,神经损伤6例。伤后至就诊时间2 h~2 d,平均7 h。肱骨髁上骨折采用闭合或切开复位克氏针固定;桡骨远端骨骺损伤或合并尺骨远端骨折(或骨骺损伤)行闭合或切开复位克氏针固定;尺桡骨干中段骨折采用闭合复位弹性钉固定。
结果 18例患儿获随访,随访时间12~18个月,平均13个月。骨折均达骨性愈合,愈合时间8周~7个月,平均3个月;神经损伤均于8周内完全恢复。1例血管损伤术后第2天可触及桡动脉搏动,11 d后彩超显示血流正常。1例患儿肘关节伸直受限约10°,其余患儿肘关节及前臂活动正常。末次随访时根据改良的Flynn标准,达优16例,良1例,可1例。
结论 浮肘损伤多发生在较高能量损伤中,易合并神经血管损伤及其他部位骨折,手术治疗可有效降低并发症发生率,提高疗效。
Citation:
王国强, 于铁强, 左玉明, 王月光, 周宏艳, 易凡, 张磊, 邢爱春. 儿童浮肘损伤的治疗. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 520-521. doi: 10.7507/1002-1892.20150111
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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Dhoju D, Shrestha D, Parajuli N, et al. Ipsilateral supracondylar fracture and forearm bone injury in children:a retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ), 2011, 9(34):11-16.
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Ring D, Waters PM, Hotchkiss RN, et al. Pediatric floating elbow. J Pediatr Orthop, 2001, 21(4):456-459.
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- 1. Tabak AY, Celebi L, Muratli HH, et al. Closed reduction and percutaneous fixation of supracondylar fracture of the humerus and ipsilateral fracture of the forearm in children. J Bone Joint Surg (Br), 2003, 85(8):1169-1172.
- 2. Blakemore LC, Cooperman DR, Thompson GH, et al. Compartment syndrome in ipsilateral humerus and forearm fractures in children. Clin Orthop Relat Res, 2000, (376):32-38.
- 3. 于铁强, 左玉明, 王月光, 等. 儿童GartlandⅣ型肱骨髁上骨折的治疗. 2014 COA论文汇编. 北京:2014.
- 4. Templeton PA, Graham HK. The ‘floating elbow’ in children. Simultaneous supracondylar fractures of the humerus and of the forearm in the same upper limb. J Bone Joint Surg (Br), 1995, 77(5):791-796.
- 5. Dhoju D, Shrestha D, Parajuli N, et al. Ipsilateral supracondylar fracture and forearm bone injury in children:a retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ), 2011, 9(34):11-16.
- 6. Ring D, Waters PM, Hotchkiss RN, et al. Pediatric floating elbow. J Pediatr Orthop, 2001, 21(4):456-459.