621000 四川 绵阳,电子科技大学医学院附属绵阳医院,绵阳市中心医院小儿外科
Received:27 November 2021,
Revised:2022-01-19,
Published:30 June 2022
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Qingsong TANG, Jian YANG, Jun LIU, et al. Sequential therapy for children with humeral lateral condyle fracture combined with elbow dislocation[J]. Journal of Army Medical University, 2022, 44(12): 1280-1284.
Qingsong TANG, Jian YANG, Jun LIU, et al. Sequential therapy for children with humeral lateral condyle fracture combined with elbow dislocation[J]. Journal of Army Medical University, 2022, 44(12): 1280-1284. DOI: 10.16016/j.2097-0927.202111200.
目的
2
评价序列治疗理念在儿童肱骨外髁骨折合并肘关节脱位中的应用价值。
方法
2
回顾性分析2010年1月至2020年12月于本院在序列治疗理念下收治的16例儿童肱骨外髁骨折合并肘关节脱位患者临床资料。序列治疗理念制订治疗方案,统计分析复位前后Jakob分型、手术前后肘外侧突起指数(lateral condylar prominence index
LCPI)、手术前后肱骨远端内外髁间宽度(intercondylar width
IEW)、Flynn肘关节评分优良率及并发症情况。
结果
2
所有病例获得随访,平均随访时间27.5(12~37)个月。复位前JakobⅠ型、JakobⅡ型与复位后JakobⅠ型、JakobⅡ型例数比较差异无统计学意义;复位前JakobⅢ型与复位后JakobⅢ型例数比较差异有统计学意义(
P
<
0.05)。术前LCPI、IEW与术后比较差异均无统计学意义。末次随访时根据Flynn肘关节评分标准评估疗效,其中优9例,良6例,可1例,优良率为93.8%。
结论
2
采用基于序列治疗理念制定的治疗方案治疗儿童肱骨外髁骨折合并肘关节脱位,治疗效果确切,尤其适于JakobⅢ型骨折,值得在临床上推广。
Objective
2
To evaluate the significance of sequential therapy concept in the treatment of humeral lateral condyle fracture combined with elbow dislocation in children.
Methods
2
A retrospective analysis was performed on the clinical data of 16 children with humeral lateral condyle fracture combined with elbow dislocation who were treated in our hospital under the concept of sequential therapy from January 2010 to December 2020. The conditions of different Jakob classification before and after reduction were observed
the lateral condylar prominence index (LCPI) and the distal humeral intercondylar width (IEW) before and after surgery were measured
and the excellent and good rate of Flynn's elbow score and complications were assessed.
Results
2
All cases were followed up for an average of 27.5 (12~37) months. There was no significant differenc
e in Jakob typesⅠandⅡbefore and after reduction
while in Jakob type Ⅲ
statistical difference was observed (
P
<
0.05). In addition
the pre- and post-operative LCPI and IEW had no significant difference. At the last follow-up
according to Flynn's elbow scale
9 cases attained excellent therapeutic efficacy
6 good
and 1 fair
with an excellent and good rate of 93.8%.
Conclusion
2
The treatment plan based on the concept of sequential therapy has a proved therapeutic effect in the treatment of children with humeral lateral condyle fracture combined with elbow dislocation
especially for fracture of Jakob type Ⅲ
which is worth clinical promotion.
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