【摘要】：目的：探討手術應用張力帶技術及保守應用石膏外固定治療不同類型兒童尺骨鷹嘴骨折的療效，以期為臨床應用提供參考。 方法：收集2012年3月—2013年10月山東中醫(yī)藥大學附屬醫(yī)院小兒骨科病房診斷為尺骨鷹嘴骨折23例。其中手術治療16例，石膏外固定保守治療7例。男性18例，女性5例，年齡3—15歲，平均9.4歲。左側(cè)11例，右側(cè)12例。骨折按照創(chuàng)傷機制分為：屈曲型12例，伸直型11例，剪切型0例。所有患者均采用影像學檢查及軟組織損傷情況評估，手術組確定手術時機，進行手術治療，術中注意保護軟組織，術后予以石膏外固定，4周拆除石膏后予以指導患者功能康復、中藥熏洗及外抹、鍛煉等措施預防并發(fā)癥的發(fā)生；保守組根據(jù)患兒骨折愈合情況予以石膏外固定4—6周，拆除固定后采取積極措施恢復肘關節(jié)功能。隨訪患兒6-12個月，平均8個月。采用Weselely等治療尺骨鷹嘴骨折的治療評定標準進行療效評估。 結果：23例患兒骨折全部愈合，根據(jù)Weselely等治療尺骨鷹嘴骨折的治療評定標準：優(yōu)18例，良4例，可1例。所有病例無感染，無骨折再移位，無骨筋膜室綜合癥，無內(nèi)固定松動，，無骨折畸形愈合及骨折延遲愈合等。 結論：尺骨鷹嘴骨折是兒童肘關節(jié)損傷中較少見的一種類型，采用張力帶技術固定及石膏外固定是治療兒童尺骨鷹嘴骨折的理想方案。選擇合適的治療方案，術中保護軟組織及患兒早期功能鍛煉可獲得滿意療效。
[Abstract]:Aim: to investigate the therapeutic effect of tension band technique and conservative plaster external fixation in the treatment of olecranon fractures in children of different types in order to provide reference for clinical application. Methods: from March 2012 to October 2013, 23 cases of ulnar olecranon fracture were diagnosed in pediatric orthopaedics ward of affiliated Hospital of Shandong University of traditional Chinese Medicine. Among them, 16 cases were treated surgically and 7 cases were treated conservatively with plaster external fixation. There were 18 males and 5 females, aged 3-15 years (mean 9.4 years). There were 11 cases on the left side and 12 cases on the right side. Fractures were divided into flexor type (n = 12), extension type (n = 11) and shear type (n = 0). All the patients were examined by imaging and the soft tissue injury was evaluated. The operation group was used to determine the time of operation, to carry out surgical treatment, to pay attention to the protection of soft tissue during the operation, and to apply plaster external fixation after operation. 4 weeks after removing gypsum to guide the patients with functional rehabilitation, traditional Chinese medicine fumigation and washing, exercise and other measures to prevent the occurrence of complications; The conservative group was treated with plaster external fixation for 4 weeks according to the healing condition of the fracture. After removal of the fixation, positive measures were taken to restore the elbow joint function. All patients were followed up for 6 months and 12 months (mean 8 months). The curative effect was evaluated by Weselely and other criteria for treatment of olecranon fracture of ulna. Results: all the fractures were healed in 23 cases. According to the criteria of Weselely et al., 18 cases were excellent, 4 cases were good and 1 case was fair. No infection, no fracture displacement, no osteofascial compartment syndrome, no loosening of internal fixation, no malunion of fracture and delayed union of fracture were found in all cases. Conclusion: olecranon fracture of ulna is a rare type of elbow joint injury in children. Tension band technique and plaster external fixation are the ideal methods for the treatment of fracture of ulnar olecranon in children. Choosing proper treatment scheme, protecting soft tissue during operation and early functional exercise in children can obtain satisfactory curative effect.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R726.8

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