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夏天.小儿桡骨头半脱位的临床特点及前臂旋前、旋后复位术的应用效果[J].中国医药科学,2023,(1):197-200        基金项目:
小儿桡骨头半脱位的临床特点及前臂旋前、旋后复位术的应用效果
Clinical characteristics of radial head subluxation in children and the application effect of forearm pronation and supination reduction
  
DOI:
中文关键词:  小儿桡骨头半脱位;手法复位;前臂旋前;前臂旋后;临床特点
英文关键词:Radial head subluxation in children; Manipulative reduction; Forearm pronation; Forearm supination; Clinical characteristics
作者单位
夏天 厦门医学院附属第二医院急诊医学科,福建厦门 361021 
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中文摘要:
      [摘要] 目的 分析小儿桡骨头半脱位的临床特点,探讨前臂旋前、旋后复位术治疗小儿桡骨头半脱位的效果。 方法 回顾性分析2019年10月至2021年4月于厦门医学院附属第二医院急诊医学科确诊为桡骨头半脱位的120例患儿。采用医院门诊HIS系统分析患儿的病史资料;按不同复位方式分为前臂旋前组(n=56)和前臂旋后组(n=64)。分析两组临床特点并比较两组复位成功率及复位后关节功能优良率(前臂旋转、肘关节屈伸功能)。结果 120例桡骨头半脱位患儿中,平均年龄(2.54±1.01)岁;女73例(60.83%)高于男47例(39.17%);受伤部位以左侧为主(70.00%);脱位时间多为12~20点(75.83%);101例(84.17%)患儿在发生桡骨头半脱位前均存在上肢被牵拉史;98例(81.67%)患儿无桡骨头半脱位病史;脱位原因主要为牵拉(82.50%)。前臂旋前组和前臂旋后组的年龄、性别、受伤部位、脱位时间、上肢牵拉史、既往桡骨头半脱位病史、脱位原因比较,差异无统计学意义(P > 0.05)。前臂旋前组第一次复位成功率及复位总成功率均明显高于前臂旋后组,差异有统计学意义(P < 0.05)。所有患儿均随访3个月,两组患儿前臂旋转功能及肘关节屈伸功能比较,差异无统计学意义(P > 0.05)。 结论 小儿桡骨头半脱位多以年龄较小的儿童为主,多为牵拉不当导致。手法复位中,前臂旋前复位和旋后复位均有较好的治疗效果,但相比旋后复位,旋前复位的成功率更高。
英文摘要:
      [Abstract] Objective To analyze the clinical characteristics of radial head subluxation in children, and to explore the effect of forearm pronation and supination reduction in the treatment of radial head subluxation in children. Methods A total of 120 children with radial head subluxation admitted to and diagnosed in the Department of Emergency Medicine of the Second Affiliated Hospital of Xiamen Medical College from October 2019 to April 2021 were retrospectively analyzed. The HIS system of the Outpatient Department was used to analyze the medical history of children. They were divided into the forearm pronation group (n=56) and the forearm supination group (n=64) according to different reduction methods. The clinical characteristics of the two groups were analyzed and the success rate of reduction and the excellent rate of joint function (forearm rotation, elbow flexion and extension function) after reduction were compared between the two groups. Results The average age of 120 children with radial head subluxation was (2.54±1.01) years. Females (73, 60.83%) were more than males (47, 39.17%). The injured site was mainly on the left side (70.00%). The subluxation occurred mostly from 12 to 20 o’clock (75.83%). 101 cases (84.17%) had a history of previous traction to the upper extremity prior to radial head subluxation. 98 cases (81.67%) had no history of radial head subluxation. The main cause of subluxation was traction (82.50%).There was no significant difference between forearm pronation group and forearm supination group in terms of age, gender, injury site, dislocation time, upper limb traction history, previous history of radial head subluxation, and causes of dislocation (P > 0.05). The first reduction success rate and total reduction success rate of the forearm pronation group were significantly higher than those of the forearm supination group, with statistically significant differences (P < 0.05). All the children were followed up for 3 months. There were no statistically significant differences in forearm rotation function and elbow flexion and extension function between the two groups (P > 0.05). Conclusion Radial head subluxation mainly occurs in younger children, and most cases are caused by improper traction. In manipulative reduction, both pronation reduction and supination reduction of the forearm have good therapeutic effects, but compared with supination reduction, the success rate of pronation reduction is higher.
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