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目的:46例儿童肱骨髁上骨折的患儿采用行手法复位后哈药外用结合弹力石膏固定,观察患部消肿、止痛和促进骨愈合的有效性。方法:46例肱骨髁上骨折患儿,随机分成两组。在非牵引状态下纠正侧方移位及旋转移位,术者双拇指按压肱骨髁上骨折部,双手余四指环抱肱骨中段背侧,使骨折部复位,骨折部向外推移少许,均屈曲90°外敷哈药后旋前位弹力管型石膏固定(纵行剖开高分子管型石膏约0.5cm)。结果:46例患儿中42例恢复正常的肘关节功能,4例(8%)遗留肘内翻,无骨髓炎发生,1例神经伤,均在短期内完全恢复感觉和功能。未发生Volkmann缺血挛缩及骨化性肌炎。结论:应用此种弹力石膏治疗方法可获得满意的固定和对肢体因肿胀压迫风险的降低,患肢肿胀期能自动撑开;消肿后自动回弹,保证有效压力内稳定骨折,并可以加压,可以减少移位的机会和调整石膏的次数,在较短时间内使肘关节恢复正常功能。外敷哈医药治疗组在消肿、止痛和促进骨折愈合方面明显优于对照组。
Objective: 46 children with supracondylar fractures of humeral pedicle after the reduction by hand Haoran external elastic plaster fixation, observation of the affected area swelling, pain and promote the effectiveness of bone healing. Methods: 46 cases of supracondylar humerus fractures were randomly divided into two groups. In the non-traction state to correct the lateral displacement and rotational displacement, the surgeon with two thumbs supracondylar humerus fractures, hands and more than four fingers around the middle of the humerus in the dorsal, the fracture reduction, fracture a little outward push a little, both buckling 90 ° external application of hay medicine after pronation elastic tube gypsum fixed (longitudinally split polymer plaster about 0.5cm). RESULTS: Of the 46 children, 42 returned to normal elbow function, 4 (8%) left elbow varus, no osteomyelitis, and 1 nerve injury completely restored their sensory and function in a short period of time. No Volkmann ischemic contracture and ossifying myositis occurred. CONCLUSIONS: The application of this elastic gypsum treatment can achieve satisfactory fixation and reduction of the risk of extremity oppression due to swelling, and the swelling of limbs can be automatically distracted. After swelling, it automatically rebounds to ensure stable fracture within effective pressure and can be added Pressure, can reduce the chance of displacement and adjust the number of plaster, the elbow in a relatively short period of time to restore normal function. External application of medicine group in the treatment of swelling, pain and promote fracture healing was significantly better than the control group.