【摘要】：目的：探討手術(shù)應(yīng)用張力帶技術(shù)及保守應(yīng)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(yīng)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(xué)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(shù)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(jī)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(xué)檢查及軟組織損傷情況評(píng)估，手術(shù)組確定手術(shù)時(shí)機(jī)，進(jìn)行手術(shù)治療，術(shù)中注意保護(hù)軟組織，術(shù)后予以石膏外固定，4周拆除石膏后予以指導(dǎo)患者功能康復(fù)、中藥熏洗及外抹、鍛煉等措施預(yù)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(fù)肘關(guān)節(jié)功能。隨訪患兒6-12個(gè)月，平均8個(gè)月。采用Weselely等治療尺骨鷹嘴骨折的治療評(píng)定標(biāo)準(zhǔn)進(jìn)行療效評(píng)估。 結(jié)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(píng)定標(biāo)準(zhǔn)：優(yōu)18例，良4例，可1例。所有病例無(wú)感染，無(wú)骨折再移位，無(wú)骨筋膜室綜合癥，無(wú)內(nèi)固定松動(dòng)，，無(wú)骨折畸形愈合及骨折延遲愈合等。 結(jié)論：尺骨鷹嘴骨折是兒童肘關(guān)節(jié)損傷中較少見的一種類型，采用張力帶技術(shù)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(shù)中保護(hù)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(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R726.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 任玉猛;尺骨鷹嘴掌側(cè)成角應(yīng)力骨折機(jī)制分析及處理體會(huì)[J];骨與關(guān)節(jié)損傷雜志;2004年04期

2 郝晨光;馬輝;邵林;楊大平;;經(jīng)雙皮質(zhì)克氏針張力帶治療尺骨鷹嘴骨折術(shù)后前臂旋后功能障礙[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2006年07期

3 亓向同,劉桂峰;張力帶內(nèi)固定術(shù)治療尺骨鷹嘴骨折46例報(bào)告[J];山東醫(yī)藥;2002年16期

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