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伸肘位手法复位形石膏夹板固定治疗小儿肱骨髁上伸直型骨折 |
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陈荣生 林晓生 郑立新 刘蔡波 余旭辉
摘 要：目的 介绍伸肘位手法复位形石膏夹板固定治疗小儿肱骨髁上伸直型骨折。 方法 在伸肘位肘关节伸屈肌均处于无张力状态，因而也是肱骨髁上骨折复位与固定的最佳位置。局部血肿内麻醉下，由助手对抗牵引，令肘关节伸直，前臂旋后位，矫正骨折移位。应用形石膏夹板绷带固定，肘关节外翻20°～30°，确使折端桡侧皮质嵌紧，直至骨质愈合。3～4周后去石膏，恢复屈肘活动。 结果 临床应用48例，骨折手法复位成功率为100.0%。经6个月～2年(平均1年2个月)的随访，肘关节伸屈功能均恢复正常，无肘内翻畸形等并发症发生。 结论 伸肘位手法复位形石膏夹板固定治疗小儿肱骨髁上伸直型骨折，能达到理想的复位和维持稳定的固定效果，可有效地遏制肘内翻畸形。
关键词：肱骨骨折； 小儿； 小夹板固定； 石膏，外科
Reduction and immobilization with type plaster splint by elbow extension for humerus supracondylar extension type fracture in children
CHEN Rongsheng LIN Xiaosheng ZHENG Lixin, et al.
（Dept. of Orthopaedic Surgery，Baoan District People's Hospital，Shenzhen 518101, China）
Abstract：Objective This article presented a method for elbow extension manipulative reduction and plaster splint immobilization to treat extension type fracture of humerus supracondylar in children. Methods When an elbow straightened, the extension and flexor muscles were both in absence of tensile force. Therefore, it was the very place to perform the reduction and immobilization for epicondylic fracture. After anethesia, while the assistant was doing counter controlateral traction to make elbow joint extend and forearm in supination position, the operator did manipulative reduction. The immobilization relied on type plaster splint bandage. Meanwhile, the elbow joint followed an eversion of 20°-30°, so that radialis cortex could be compacted well. After 3-4 weeks, the plaster should be moved away and the elbow allowed movements. Results The method was applied for 48 cases, all of which recovered totally. A follow-up study for 6 months to 2 years (average 1 year and 2 months) showed that the extension and flexor function of elbow joints returned to normal without any complications like elbow inversion. Conclusions This suggests that the new method will be ideal for reducion and immobiliation of the humeral supracondylar fracture and effective to pr[1] [2] 下一页
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