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目的总结儿童浮肘损伤的特点,根据骨折部位进行分型并探讨治疗方法及疗效。方法回顾性分析自2008-01—2014-06诊治的26例儿童浮肘损伤,根据骨折部位及儿童存在骨骺的特点将浮肘损伤分为3个类型:Ⅰ型为肱骨干骨折并尺桡骨干骨折,Ⅱ型为至少一侧为干骺端骨折,Ⅲ型为至少一侧存在骨骺损伤。根据患儿年龄、骨折类型选择治疗方法及固定方式。结果 24例获得随访,随访时间12~18个月,平均14个月。骨折均骨性愈合,未发生骨折不愈合,神经损伤均在8周内完全恢复。末次随访时根据改良Flynn标准评定疗效:优20例,良4例。1例Ⅱ型、2例Ⅲ型骨折患儿肘关节活动受限约10°,1例Ⅲ型患儿肘内翻约5°(健侧肘外翻约5°)。结论儿童浮肘损伤分型考虑了儿童上肢解剖特点,分型简单,便于记忆与临床使用,同时根据年龄、分型个性化治疗浮肘损伤效果良好。
Objective To summarize the characteristics of children ’s floating elbow injury, according to the fracture site classification and explore the treatment and efficacy. Methods A retrospective analysis of 26 cases of children with floating elbow injuries diagnosed from January 2008 to June 2006 was made. According to the characteristics of the fracture sites and the presence of epiphysis in children, the elbow injuries were divided into three types: Ⅰ type was humeral shaft fractures and ulna and radius trunk Fracture, type Ⅱ for at least one side of the metaphyseal fracture, type Ⅲ for at least one side there epiphyseal injury. According to children’s age, type of fracture treatment options and methods of fixation. Results 24 cases were followed up for 12 to 18 months with an average of 14 months. Bone fractures were healed, nonunion did not occur, the nerve injury were completely recovered within 8 weeks. The final follow-up evaluation based on modified Flynn criteria: excellent in 20 cases, good in 4 cases. One case of type Ⅱ and 2 cases of type Ⅲ fracture had limited elbow mobility of about 10 °. One case of type Ⅲ had a cubitus varus of about 5 ° (elbow valgus about 5 °). Conclusion The children’s elbow injury classification considers the anatomical features of the upper limbs of children with simple typing and is convenient for memory and clinical use. At the same time, it is effective to treat floating elbow injuries according to age and type.