儿童浮肘损伤的治疗_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

王国强 ,  于铁强 , 左玉明 , 王月光 , 周宏艳 , 易凡 , 张磊 , 邢爱春

唐山市第二医院小儿骨科（河北唐山，063000）;

Corresponding author：

于铁强, Email: unicornfly@live.cn

Keywords：

浮肘损伤; 手术治疗; 儿童

DOI：

10.7507/1002-1892.20150111

Video：

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目的总结儿童浮肘损伤的临床特点、治疗方法及疗效。方法回顾分析2008年1月－2013年12月收治的19例浮肘损伤患儿临床资料，男14例，女5例；年龄14个月～13岁7个月，平均8岁。肱骨髁上骨折均为Gartland Ⅲ型。开放骨折1例，合并血管损伤1例，神经损伤6例。伤后至就诊时间2 h～2 d，平均7 h。肱骨髁上骨折采用闭合或切开复位克氏针固定；桡骨远端骨骺损伤或合并尺骨远端骨折（或骨骺损伤）行闭合或切开复位克氏针固定；尺桡骨干中段骨折采用闭合复位弹性钉固定。结果 18例患儿获随访，随访时间12～18个月，平均13个月。骨折均达骨性愈合，愈合时间8周～7个月，平均3个月；神经损伤均于8周内完全恢复。1例血管损伤术后第2天可触及桡动脉搏动，11 d后彩超显示血流正常。1例患儿肘关节伸直受限约10°，其余患儿肘关节及前臂活动正常。末次随访时根据改良的Flynn标准，达优16例，良1例，可1例。结论浮肘损伤多发生在较高能量损伤中，易合并神经血管损伤及其他部位骨折，手术治疗可有效降低并发症发生率，提高疗效。

Citation： 王国强, 于铁强, 左玉明, 王月光, 周宏艳, 易凡, 张磊, 邢爱春. 儿童浮肘损伤的治疗. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 520-521. doi: 10.7507/1002-1892.20150111 Copy

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2.	Blakemore LC, Cooperman DR, Thompson GH, et al. Compartment syndrome in ipsilateral humerus and forearm fractures in children. Clin Orthop Relat Res, 2000, (376):32-38.
3.	于铁强, 左玉明, 王月光, 等. 儿童GartlandⅣ型肱骨髁上骨折的治疗. 2014 COA论文汇编. 北京:2014.
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5.	Dhoju D, Shrestha D, Parajuli N, et al. Ipsilateral supracondylar fracture and forearm bone injury in children:a retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ), 2011, 9(34):11-16.
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1. Tabak AY, Celebi L, Muratli HH, et al. Closed reduction and percutaneous fixation of supracondylar fracture of the humerus and ipsilateral fracture of the forearm in children. J Bone Joint Surg (Br), 2003, 85(8):1169-1172.
2. Blakemore LC, Cooperman DR, Thompson GH, et al. Compartment syndrome in ipsilateral humerus and forearm fractures in children. Clin Orthop Relat Res, 2000, (376):32-38.
3. 于铁强, 左玉明, 王月光, 等. 儿童GartlandⅣ型肱骨髁上骨折的治疗. 2014 COA论文汇编. 北京:2014.
4. Templeton PA, Graham HK. The ‘floating elbow’ in children. Simultaneous supracondylar fractures of the humerus and of the forearm in the same upper limb. J Bone Joint Surg (Br), 1995, 77(5):791-796.
5. Dhoju D, Shrestha D, Parajuli N, et al. Ipsilateral supracondylar fracture and forearm bone injury in children:a retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ), 2011, 9(34):11-16.
6. Ring D, Waters PM, Hotchkiss RN, et al. Pediatric floating elbow. J Pediatr Orthop, 2001, 21(4):456-459.

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Chinese Journal of Reparative and Reconstructive Surgery

儿童浮肘损伤的治疗

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