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目的探讨儿童肱骨髁上骨折伴桡神经损伤的手术治疗效果。方法通过回顾性分析上海市儿童医院收治的儿童肱骨髁上骨折伴桡神经损伤的患儿41例的临床资料,将其分为2组。研究组为肱骨髁上骨折切开复位并行Ⅰ期神经探查修复;对照组为肱骨髁上骨折外院处理骨折愈合后伴神经损伤,术后2～4个月至本院进行Ⅱ期神经探查修复。对2组患儿在神经修复治疗后功能恢复情况进行分析。结果研究组18例中疗效优13例、良4例、一般1例,优良率为94.44%;对照组23例中疗效优6例、良12例、一般3例、差2例,优良率仅为78.26%。Ⅰ期手术患儿桡神经功能恢复优良率要优于Ⅱ期手术患儿(P=0.028)。结论儿童肱骨髁上骨折伴桡神经损伤,Ⅰ期处理骨折的同时积极处理损伤的桡神经,能取得满意疗效。
Objective To investigate the surgical treatment of supracondylar humerus fractures with radial nerve injury in children. Methods The clinical data of 41 children with supracondylar fracture of humerus and radial nerve injury admitted to Shanghai Children’s Hospital were retrospectively analyzed and divided into two groups. The study group was performed resection of the supracondylar fractures of humerus in combination with stage Ⅰ nerve exploration and repair. The control group was treated with supracondylar fractures of the humerus and was treated with nerve injury after fracture healing. The patients were followed up for neurological exploration in our hospital from 2 to 4 months after operation. The functional recovery of the two groups of children after nerve repair was analyzed. Results In the study group, the curative effect was excellent in 13 cases, good in 4 cases and normal in 1 case, the excellent and good rate was 94.44%. In the control group, the curative effect was excellent in 6 cases, good in 12 cases, fair in 3 cases and poor in 2 cases. 78.26%. The excellent rate of radial nerve function recovery in stage Ⅰ operation was better than that in stage Ⅱ operation (P = 0.028). Conclusions The supracondylar fracture of the humerus is associated with radial nerve injury. In the treatment of fractures, the injured radial nerve can be treated actively in the first stage, and the satisfactory curative effect can be obtained.