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目的:探讨儿童肱骨髁上严重骨折的临床特点及治疗方法。方法:收集2008—2010年我院收治的肱骨髁上严重骨折(GartlandШ型)儿童53例,其中闭合性损伤40例,开放性损伤13例,其中35例予以闭合复位穿刺针固定,18例行切开复位并神经血管探查,术后行功能康复训练,通过随访并以Casse-baum等肘关节评分系统评价肘关节功能,比较两种治疗方法的临床疗效。结果:随访1年,53例患者神经功能均完全恢复,切开复位者神经、肘关节功能完全恢复时间与闭合复位穿刺针固定者无显著差异。结论:闭合复位穿刺针固定与切开复位并神经血管探查两种方法治疗儿童肱骨髁上严重骨折无显著差异,临床治疗中可根据实际情况选择不同的治疗方式。
Objective: To investigate the clinical features and treatment of severe fractures of the humerus in children. Methods: Fifty-three children with severe supracondylar humerus fractures (Gartland type) admitted in our hospital from 2008 to 2010 were enrolled in this study. Among them, 40 had closed injury and 13 had open injury. Among them, 35 were treated with closed reduction and puncture needle fixation and 18 Open reduction and neurovascular exploration, postoperative functional rehabilitation training, follow-up and assessment of elbow joint function with the elbow joint rating system such as Casse-baum, the clinical efficacy of the two treatment methods were compared. Results: After one year of follow-up, the neurological function of 53 patients recovered completely. The nerves of the patients undergoing resection were completely repaired. There was no significant difference between the two groups in the complete recovery time of the elbow joint and the fixation of the closed reduction needle. Conclusion: There are no significant differences in the treatment of children with severe fractures of the humerus in both fixation and open reduction and neurovascular exploration. In the clinical treatment, different treatments may be selected according to the actual situation.