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目的探讨不同方法治疗儿童肱骨髁上骨折的疗效。方法诊断为肱骨髁上骨折78例患儿,依据知情、自愿及随机原则分为观察组和对照组。观察组46例,采用中医手法复位配合小夹板外固定治疗,对照组32例,采用西医切开复位克氏针内固定治疗,观察骨折愈合情况、肘内翻发生率及肘关节功能恢复情况。结果观察组愈合时间、早期肘关节功能恢复优于对照组,差异具有统计学意义(P<0.01),8周后差异无统计学意义(P>0.05)。肘内翻发生率方面,对照组优于观察组,差异无统计学意义(P>0.05)。结论手法复位治疗儿童肱骨髁上骨折适用于无移位或轻度移位的稳定性骨折,McIntyreⅢa、Ⅲb等严重移位的不稳定骨折,应采用切开复位内固定,能有效降低肘内翻。
Objective To investigate the curative effect of different methods on supracondylar humerus fractures in children. Methods 78 cases of supracondylar fracture of humerus were diagnosed, and were divided into observation group and control group according to the principle of informed, voluntary and random. 46 cases in the observation group were treated with reduction of traditional Chinese medicine and external fixation with small splint. The control group was treated by open reduction and internal fixation with Kirschner wire. The fracture healing, the incidence of cubitus varus and the elbow recovery were observed. Results The healing time of the observation group and the recovery of early elbow joint function were better than those of the control group (P <0.01). There was no significant difference after 8 weeks (P> 0.05). The incidence of cubitus varus, the control group was better than the observation group, the difference was not statistically significant (P> 0.05). Conclusions Manipulative reduction of supracondylar fracture of humerus in pediatric patients is suitable for stable fractures without displacement or mild displacement, unstable fractures such as McIntyre Ⅲ a and Ⅲ b, which should be treated with open reduction and internal fixation and can effectively reduce cubitus varus .