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目的:回顾性研究不稳定性儿童肱骨近端骨骺骨折的治疗,总结体位性尺骨鹰嘴牵引对经闭合手法复位后的骨位稳定效果和临床意义。方法:2005年1月～2012年1月期间的35例不稳定性肱骨近端骨骺骨折住院儿童,均采用闭合手法复位,卧位肩前屈90°位尺骨鹰嘴牵引治疗。院外6～12月随访,平均9个月。采用Constant-Murley绝对值评分方法进行疗效评价。结果:35例患儿均在整复术后6～8周临床愈合,随访期末评分优33例,良1例,可1例;未出现肱骨头坏死病例。结论:闭合手法复位后,卧位肩前屈90°位尺骨鹰嘴牵引治疗能有效维持肱骨近端骨骺骨折的断端稳定,提供良好肩关节功能恢复的解剖条件。
Objective: To retrospectively study the treatment of proximal humerus epiphysis fracture in unstable children, and to summarize the effect and clinical significance of the stabilization of the position of the bones after orthopedic olecranon traction on closed reduction. Methods: From January 2005 to January 2012, 35 cases of unstable proximal humeral epiphyseal fracture hospitalized children were treated with closed reduction and lateral flexion of 90 ° ulnar olecranon traction. 6 to 12 months follow-up outside the hospital, an average of 9 months. The efficacy of Constant-Murley score was evaluated. Results: All the 35 cases were cured 6 to 8 weeks after the operation. The end of follow-up period was excellent in 33 cases, good in 1 case and fair in 1 case. No cases of humeral head necrosis occurred. CONCLUSION: After closed reduction, the ulnar flexion with 90 ° lateral flexion can effectively maintain the fracture stability of proximal epiphyseal fracture of the humerus and provide anatomical conditions for good shoulder function recovery.