切开复位与关节镜治疗儿童肱骨外髁骨折的疗效对比
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青岛大学

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Comparison of the efficacy of open reduction and arthroscopy in the treatment of lateral humeral condylar fracture in children
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Qingdao University

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    摘要:

    目的:探讨关节镜治疗与切开复位治疗儿童肱骨外髁骨折的临床疗效对比。方法:回顾性分析自2019年12月至2021年12月在青岛市妇女儿童医院关节镜治疗的肱骨外髁骨折101例患儿的临床资料,根据医患沟通结果,31例采取切开复位治疗,70例采取关节镜治疗。比较两组术前、围术期、随访及影像结果。结果:两组患儿在术前资料及随访时间上均无统计学差异,两组患儿骨折均愈合,无非计划二次手术、感染、骨不连、骨桥形成、肘内外翻等并发症的发生。但两组在手术时间、切口大小、住院天数、术后取钉时间、取钉术后3月肘关节屈伸活动受限方面差异有统计学意义,关节镜组优于切开组(P<0.05);在侧方骨刺的发生、末次随访Mayo肘关节功能评分、末次随访肘关节屈伸活动受限方面两组差异无统计学意义(P>0.05)。结论:随着运动医学和关节镜技术的发展,关节镜技术日趋成熟,为不能闭合复位的儿童肱骨外髁骨折提供了微创可能性,关节镜下复位经皮内固定术治疗儿童肱骨外髁骨折,切口小,恢复时间快且临床疗效确切,无严重并发症发生,在熟练掌握后可成为治疗儿童肱骨外髁骨折的新选择。

    Abstract:

    Objective : To compare the clinical efficacy of arthroscopic treatment and open reduction in the treatment of humeral lateral condyle frac tures in children. Methods : The clinical data of 101 children with lateral condyle fracture of humerus treated by arthroscopy in Qingdao Women and Children ''s Hospital from December 2019 to December 2021 were retrospectively analyzed. According to the results of doctor-patient communication, 31 cases were treated with open reduction and 70 cases were treated with arthroscopy. The preoperative, follow-up and imaging results were compared between the two groups. Results : There was no significant difference in preoperative data and follow-up time between the two groups. The fractures of the two groups were healed, and there were no unplanned secondary surgery, infection, nonunion, bone bridge formation, cubitus varus or cubitus valgus and other complications. However, there were statistically significant differences between the two groups in terms of operation time, incision size, hospitalization days, postoperative nail removal time, and limited elbow flexion and extension activity 3 months after nail removal. The arthroscopic group was superior to the incision group ( P<0.05 ). Here was no significant difference between the two groups in the occurrence of lateral bone spurs, the Mayo elbow function score at the last follow-up, and the limitation of elbow flexion and extension at the last follow-up ( P>0.05 ).With the development of sports medicine and arthroscopic technology, arthroscopic technology is becoming more and more mature, which provides a minimally invasive possibility for children ''s lateral humeral condyle fractures that cannot be closed reduction. Arthroscopic reduction and percutaneous internal fixation for the treatment of children ''s lateral humeral condyle fractures has the advantages of small incision, fast recovery time, definite clinical efficacy and no serious complications. It can become a new choice for the treatment of children ''s lateral humeral condyle fractures after mastering it.

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  • 收稿日期:2023-09-11
  • 最后修改日期:2023-09-11
  • 录用日期:2023-10-27
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