84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]曹慎,曹謙,湯智,等.楊氏手法復(fù)位環(huán)形墊超肘夾板“8”字固定治療兒童移位型肱骨外髁骨折的臨床研究[J].中醫(yī)正骨,2019,31(11):1-6.
　CAO Shen,CAO Qian,TANG Zhi,et al.A clinical study of Yang's manipulative reduction combined with figure-of-eight fixation with ring-shaped pads and transarticular splints for treatment of displaced humeral lateral condyle fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(11):1-6.
點(diǎn)擊復(fù)制

楊氏手法復(fù)位環(huán)形墊超肘夾板“8”字固定治療兒童移位型肱骨外髁骨折的臨床研究()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年11期
頁碼:
1-6
欄目:
臨床研究
出版日期:
2019-11-20

文章信息/Info

Title:
A clinical study of Yang's manipulative reduction combined with figure-of-eight fixation with ring-shaped pads and transarticular splints for treatment of displaced humeral lateral condyle fractures in children
作者:
曹慎; 曹謙; 湯智; 楊韻琴
(湘潭市中醫(yī)醫(yī)院,湖南 湘潭 411100)
Author(s):
CAO Shen; CAO Qian; TANG Zhi; YANG Yunqin
Xiangtan Hospital of Traditional Chinese Medicine,Xiangtan 411100,Hunan,China
關(guān)鍵詞:
肘關(guān)節(jié);  肱骨骨折;  正骨手法;  小夾板固定;  兒童;  臨床試驗(yàn)
Keywords:
elbow joint;  humeral fractures;  bone setting manipulation;  small splint fixation;  child;  clinical trial
摘要:
目的:觀察楊氏手法復(fù)位環(huán)形墊超肘夾板“8”字固定治療兒童移位型肱骨外髁骨折的臨床療效和安全性。方法:以2017年3月至2018年11月在湘潭市中醫(yī)醫(yī)院住院治療的JacobⅡ、Ⅲ型肱骨外髁骨折患兒為研究對象。采用隨機(jī)數(shù)字表將符合要求的患者隨機(jī)分為非手術(shù)組和手術(shù)組。非手術(shù)組采用楊氏手法復(fù)位環(huán)形墊超肘夾板“8”字固定治療,手術(shù)組采用切開復(fù)位克氏針內(nèi)固定加石膏外固定治療。觀察記錄患者的雙側(cè)肘關(guān)節(jié)周徑差、住院時間、治療費(fèi)用、骨折愈合情況及Baumann角,采用Broberg-Morrey肘關(guān)節(jié)評分量表評定總體療效。同時觀察記錄治療及隨訪期間的并發(fā)癥發(fā)生情況。結(jié)果:共納入60例患者,非手術(shù)組和手術(shù)組各30例。2組患者的雙側(cè)肘關(guān)節(jié)周徑差總體比較,組間差異無統(tǒng)計(jì)學(xué)意義,即不存在分組效應(yīng)(F=8.325,P=0.522)。時間因素和分組因素存在交互效應(yīng)(F=26.140,P=0.000)。治療前后不同時點(diǎn)間雙側(cè)肘關(guān)節(jié)周徑差的差異有統(tǒng)計(jì)學(xué)意義,即存在時間效應(yīng)(F=19.060,P=0.000); 2組患者的雙側(cè)肘關(guān)節(jié)周徑差隨時間變化均呈降低趨勢,但2組的降低趨勢不完全一致(F=11.070,P=0.000; F=25.100,P=0.000); 治療前和治療后28 d,2組患者的雙側(cè)肘關(guān)節(jié)周徑差比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(7.00±0.50)cm,(6.80±0.53)cm,t=1.456,P=0.156;(0.90±0.19)cm,(1.00±0.21)cm,t=-0.783,P=0.440]; 治療后7 d、14 d時,非手術(shù)組的雙側(cè)肘關(guān)節(jié)周徑差均小于手術(shù)組[(3.10±0.47)cm,(4.30±0.73)cm,t=6.111,P=0.000;(1.00±0.21)cm,(1.10±0.24)cm,t=-2.431,P=0.021]。與手術(shù)組相比,非手術(shù)組的住院時間短、治療費(fèi)用低[(6.00±1.03)d,(8.80±1.71)d,t=-8.015,P=0.000;(2 621.40±304.93)元,(8 061.70±766.67)元,t=-37.917,P=0.000]。2組患者的骨折均愈合良好,未發(fā)生骨折延遲愈合或不愈合。治療后6個月時,2組患者的Baumman角、Broberg-Morrey評分比較,組間差異均無統(tǒng)計(jì)學(xué)意義[3.20°±0.34°,3.30°±0.37°,t=-1.086,P=0.287;(92.10±2.36)分,(92.60±1.96)分,t=-0.916,P=0.367]。2組患者治療及隨訪期間均未出現(xiàn)并發(fā)癥。結(jié)論:楊氏手法復(fù)位環(huán)形墊超肘夾板“8”字固定是治療兒童移位型肱骨外髁骨折的有效方法,其療效和安全性與切開復(fù)位克氏針內(nèi)固定治療相當(dāng); 但與切開復(fù)位克氏針內(nèi)固定治療相比,治療后患肢腫脹消退更快、住院時間更短、治療費(fèi)用更低。
Abstract:
Objective:To observe the clinical curative effects and safety of Yang's manipulative reduction combined with figure-of-eight fixation with ring-shaped pads and transarticular splints for treatment of displaced humeral lateral condyle fractures in children.Methods:The children with Jacob typeⅡandⅢhumeral lateral condyle fractures who were treated in Xiangtan Hospital of Traditional Chinese Medicine from March 2017 to November 2018 were selected as the subjects.Sixty children were enrolled in the study and were randomly divided into operative group and non-operative group by using random digits table,30 cases in each group.The children in non-operative group were treated with Yang's manipulative reduction combined with figure-of-eight fixation with ring-shaped pads and transarticular splints,while the children in operative group were treated with open reduction combined with Kirschner wire internal fixation and plaster external fixation.The difference of circumference between bilateral elbow joints,hospital stays,cost of treatment,fracture healing and Baumann angles were observed and recorded respectively,and the total clinical curative effects were evaluated by using Broberg-Morrey elbow scoring scale.Meanwhile,the complication incidences were observed and recorded during the treatment and follow-up period.Results:In general,there was no statistical difference between the 2 groups in the difference of circumference between bilateral elbow joints,in other words,there was no group effect(F=8.325,P=0.522).There was interaction between time factor and group factor(F=26.140,P=0.000).There was statistical difference in the difference of circumference between bilateral elbow joints between different timepoints before and after treatment,in other words,there was time effect(F=19.060,P=0.000).The difference of circumference between bilateral elbow joints presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(F=11.070,P=0.000; F=25.100,P=0.000).There was no statistical difference in the difference of circumference between bilateral elbow joints between the 2 groups before the treatment and at 28 days after the treatment(7.00+/-0.50 vs 6.80+/-0.53 cm,t=1.456,P=0.156; 0.90+/-0.19 vs 1.00+/-0.21 cm,t=-0.783,P=0.440).The difference of circumference between bilateral elbow joints was less in non-operative group compared to operative group at 7 and 14 days after the treatment(3.10+/-0.47 vs 4.30+/-0.73 cm,t=6.111,P=0.000; 1.00+/-0.21 vs 1.10+/-0.24 cm,t=-2.431,P=0.021).The cost of treatment was lower and the hospital stay was shorter in non-operative group compared to operative group(2 621.40+/-304.93 vs 8 061.70+/-766.67 RMB,t=-37.917,P=0.000; 6.00+/-1.03 vs 8.80+/-1.71 days,t=-8.015,P=0.000).All fractures healed well,and no delayed union and nonunion of fractures were found in the 2 groups.There was no statistical difference in Baumann angles and Broberg-Morrey scores between the 2 groups at 6 months after the treatment(3.20+/-0.34 vs 3.30+/-0.37 degrees,t=-1.086,P=0.287; 92.10+/-2.36 vs 92.60+/-1.96 points,t=-0.916,P=0.367).No complications were found in the 2 groups during the treatment and follow-up period.Conclusion:Yang's manipulative reduction and figure-of-eight fixation with ring-shaped pads and transarticular splints is effective for treating displaced humeral lateral condyle fractures in children,and it is similar to open reduction and Kirschner wire internal fixation in clinical curative effects and safety,while the former has such advantages as faster posttreatment swelling subsidence in affected limbs,shorter hospital stays and lower cost of treatment compared to the latter.

參考文獻(xiàn)/References:

[1] TEJWANI N,PHILLIPS D,GOLDSTEIN R Y.Management of lateral humeral condylar fracture in children[J].J Am Acad Orthop Surg,2011,19(6):350-358. [2] 王浩,劉智.兒童肱骨外髁骨折治療現(xiàn)狀[J].實(shí)用骨科雜志,2015,21(9):817-821. [3] 周慶和,劉遠(yuǎn)忠,陳偉東.不同類型兒童肱骨外髁骨折的療效分析及并發(fā)癥[J].廣東醫(yī)學(xué),2017,38(S1):126-127. [4] SALGUEIRO L,ROOCROFT J H,BASTROM T P,et al.Rate and risk factors for delayed healing following surgical treatment of lateral condyle humerus fractures in children[J].J Pediatr Orthop,2017,37(1):1-6. [5] BLAND D C,PENNOCK A T,UPASANI V V,et al.Measurement reliability in pediatric lateral condyle fractures of the humerus[J].J Pediatr Orthop,2018,38(8):e429-e433. [6] SHARMA H,SIBINSKI M,SHERLOCK D A.Outcome of lateral humeral condylar mass fractures in children associated with elbow dislocation or olecranon fracture[J].Int Orthop,2009,33(2):509-514. [7] 王亦璁,姜保國.骨與關(guān)節(jié)損傷[M].5版.北京:人民衛(wèi)生出版社,2012:846-848. [8] 陳星光,陸敏華,陸琳,等.可吸收材料及克氏針內(nèi)固定治療兒童肱骨外髁骨折療效的Meta分析[J].中國組織工程研究,2018,22(14):2290-2296. [9] ARIZMENDI A,LOZANO-CALDERÓN S,RING D C,et al.Elbow dislocation and articular fracture of the distal humerus[J].中華創(chuàng)傷骨科雜志,2006,8(9):801-805. [10] LEONIDOU A,CHETTIAR K,GRAHAM S,et al.Open reduction internal fixation of lateral humeral condyle fractures in children.A series of 105 fractures from a single institution[J].Strategies Trauma Limb Reconstr,2014,9(2):73-78. [11] PIRKER M E,WEINBERG A M,HÖLLWARTH M E,et al.Subsequent displacement of initially nondisplaced and minimally displaced fractures of the lateral humeral condyle in children[J].Krauma,2010,46(5):953-958. [12] LAUNAY F,LEET A,JACOPIN S,et al.Lateral humeral condyle fractures in children:a comparison of two approaches to treatment[J].J Pediatr Orthop,2004,24(4):385-391.

相似文獻(xiàn)/References:

[1]陳紅衛(wèi),王子陽,李軍,等.肘關(guān)節(jié)后外側(cè)入路聯(lián)合前內(nèi)側(cè)入路治療 肘關(guān)節(jié)恐怖三聯(lián)征[J].中醫(yī)正骨,2015,27(09):40.
[2]邢金明.切開復(fù)位鎖定鋼板內(nèi)固定術(shù)和人工半肩關(guān)節(jié)置換術(shù) 治療老年肱骨近端復(fù)雜骨折的對比研究[J].中醫(yī)正骨,2015,27(08):11.
　XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(11):11.
[3]任維龍,李剛,許波,等.骨原發(fā)性非霍奇金淋巴瘤1例[J].中醫(yī)正骨,2015,27(02):73.
[4]翟利鋒,陳億民,許樺,等.經(jīng)指伸肌劈開入路治療MasonⅡ型橈骨頭骨折[J].中醫(yī)正骨,2015,27(06):59.
[5]鄧明月,徐虹霞,胡曉川,等.關(guān)節(jié)鏡下松解術(shù)治療肘關(guān)節(jié)僵硬的護(hù)理方法[J].中醫(yī)正骨,2015,27(06):73.
[6]丁方平,王人彥,楊寅.“4點(diǎn)法”小針刀松解術(shù)治療肘關(guān)節(jié)僵硬[J].中醫(yī)正骨,2015,27(05):29.
[7]盛紅楓,張玉柱.微創(chuàng)鎖定鋼板內(nèi)固定配合中藥內(nèi)服治療肱骨近端骨折[J].中醫(yī)正骨,2015,27(04):49.
[8]孫燕,何東,孫煒,等.外側(cè)楔形截骨矯正兒童肘內(nèi)翻畸形手術(shù)中內(nèi)固定方式的選擇[J].中醫(yī)正骨,2016,28(01):43.
[9]孫鵬,譚磊,閻乾,等.人工肱骨頭置換術(shù)治療老年肱骨近端Neer三、四部分骨折[J].中醫(yī)正骨,2016,28(05):43.
[10]方 銘.“T”形雙切口鎖定鋼板內(nèi)固定治療老年肱骨近端骨折[J].中醫(yī)正骨,2016,28(05):46.
[11]蔣擁軍,李克軍,陳佳旭,等.榮肌揉筋手法治療成人肱骨髁間骨折術(shù)后肘關(guān)節(jié)僵硬[J].中醫(yī)正骨,2016,28(06):21.
　JIANG Yongjun,LI Kejun,CHEN Jiaxu,et al.Rongji Roujin(榮肌揉筋)manipulation for treatment of postoperative elbow joint stiffness in adults with humeral intercondylar fracture[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(11):21.
[12]張小白,羅漫麗.應(yīng)用動靜平衡原則指導(dǎo)兒童肱骨髁上骨折術(shù)后功能鍛煉[J].中醫(yī)正骨,2019,31(07):77.
[13]劉鴻豪,趙云昌,趙春節(jié).閉合復(fù)位改良外側(cè)交叉克氏針內(nèi)固定治療兒童GartlandⅡ、Ⅲ型肱骨髁上骨折的臨床研究[J].中醫(yī)正骨,2019,31(11):7.
　LIU Honghao,ZHAO Yunchang,ZHAO Chunjie.A clinical study of closed reduction and modified lateral cross Kirschner wire internal fixation for treatment of Gartland typeⅡandⅢhumeral supracondylar fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(11):7.

備注/Memo

備注/Memo:
基金項(xiàng)目:湖南省中醫(yī)藥管理局科研計(jì)劃項(xiàng)目(2017151) 通訊作者:湯智 E-mail:[email protected](收稿日期:2019-06-21 本文編輯:李曉樂)
更新日期/Last Update: 2019-11-10