摘要
目的:观察肱骨髁上骨折的儿童采用闭合手法复位交叉克氏针固定治疗方法的临床效果分析.方法:所有病例均为2019年3月-2023年1月符合标准的35例儿童肱骨髁上骨折患者,都应用闭合手法复位交叉克氏针固定,术后肘关节石膏固定屈肘45°～60°制动3周;分别对患者治疗前、治疗后3周、治疗后3月进行随访,根据VAS疼痛评分和改良An和Morrey肘关节功能评分依次评估患者肘关节的疼痛评分、运动范围评分、力量评分、临床效果,计算分值进行统计分析,以观察肘关节手术的治疗效果.结果:术前、术后3周、术后3月之间的疼痛、肘关节运动范围、肘关节力量、临床效果进行比较,术后3周、术后3月肘关节疼痛、运动范围、力量、临床效果较术前明显改善(P＜0.05).组之间两两比较,术后3周与术前相比在疼痛、肘关节运动范围、肘关节力量、临床效果方面明显改善(P＜0.05).但由于术后3周内石膏辅助肘关节固定,克氏针经皮肤等原因导致患者在疼痛、肘关节运动范围、肘关节力量、临床效果方面恢复满意度明显低于术后3月(P＜0.05).结论:肱骨髁上骨折的儿童应用闭合手法复位克氏针固定后肘关节疼痛、运动范围、力量、临床效果明显改善,效果满意.
Abstract
Objective:To observe the clinical effects of closed reduction and crossed Kirschner wire fixation in chil-dren with supracondylar humeral fractures.Methods:All cases were 35 children with supracondylar humeral fractures who met the criteria from March 2019 to January 2023.Closed manual reduction and cross-K-wire fixation were used,and the postoperative elbow joints were fixed with plaster and the elbows were flexed 45 ° to 60 °.Immobilization for 3 weeks;the patients were followed up before treatment,3 weeks after treatment,and 3 months after treatment.The patients'elbow joint pain score,range of motion score,and Strength scores,clinical effects,and calculated scores were analyzed statistically to observe the therapeutic effect of elbow joint surgery.Results:The pain,elbow joint range of motion,elbow joint strength,and clinical effects were compared before surgery,3 weeks after surgery,and 3 months af-ter surgery.Elbow joint pain,range of motion,and strength were compared between 3 weeks after surgery,and 3 months after surgery.The clinical effect was significantly improved compared with that before surgery(P＜0.05).Pairwise com-parisons between groups showed that pain,elbow joint range of motion,elbow joint strength,and clinical effects were significantly improved 3 weeks after surgery compared with before surgery(P＜0.05).However,due to plaster-assisted elbow joint fixation and Kirschner wire penetration through the skin within 3 weeks after surgery,the patient's recov-ery satisfaction in terms of pain,elbow joint range of motion,elbow joint strength,and clinical effects was significantly lower than 3 months after surgery(P＜0.05).Conclusion:For children with supracondylar humerus fractures,elbow joint pain,range of motion,strength,and clinical effects are significantly improved after closed manipulation reduction and Kirschner wire fixation,and the results are satisfactory.
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