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1、儿童前臂双骨折中西医结合治疗［摘要］目的:在儿童前臂双骨折治疗中，采用更适宜的治疗方案来提高治疗效果，以减少并发症。方法:选择76例5~12岁的闭合移位前臂双骨折患儿，其中,60例不同类型的骨折行手法复位小夹板或石膏托外固定，不成功者给予手术治疗;16例早期直接行手术切开复位钢板螺丝钉或克氏针内固定，以后二次手术取出内固定物。结果：60例手法复位患儿中,54例手法复位成功，成功率为90%,骨折愈合时间为33~50d;6例手法复位不成功，行手术切开复位钢板螺丝钉内固定,愈合时间为80-102do16例直接手术治疗的患儿中,14例愈
2、合时间为80-160d,平均7-12个月取出内固定物;1例伤后就诊时间长，造成前臂肌间隔综合征,行手术切开减压加克氏针内固定，二期植皮，术后半年骨折愈合例尺骨骨不连，需再次手术重新内固定加植骨术，术后1年愈合。结论:儿童前臂双骨折早期行手法复位非常重要，而旋转移位是前臂双骨折复位的难点，手术治疗不能作为首选,应充分运用中西医结合治疗骨折的理念，提高治疗效果。［关键词］儿童;前臂双骨折;中西医结合治疗［中图分类号］R683.41［文献标识码］A［文章编号］1673-7210(2010)03(3)-025-02IntegratedC
3、hineseandWesternmedicinetreatmentofdoubleforearmfracturesinchildrenYANGDongliang,HUANGLi,WANGLide(TheChineseMedicineHospitalofXinhuiDistrictofJiangmenCity,GuangdongProvince,Jiangmen529100,China)[Abstract]Objective:Toevaluatethetreatmentofdoubleforearmfracturesinchild
4、renfortheadoptionofamoreappropriatetreatmentprogramstoreducecomplications.Methods:76casesof5-12-year-oldchildrenwithdoublecloseddisplacedfractureoftheforearmwereselected,ofwhich60childrenwithdifferenttypesoffracturesunderwentasmallexternalfixationsplintsorplaster,the
5、unsuccessfulcasesunderwentsurgicaltreatment;16childrenunderwentearlydirectsurgicalopenreductionandplatefixationwithscrewsorKirschnerwire,theinternalfixationwasremovedinthesecondoperation.Results:In60childrenofmanualreduction,54childrenobtainedsuccessfultreatment,thes
6、uccessratewas90%,fracturehealingtimewas33to50days・6childrenofmanualreductionwereunsuccessful,andbeoperatedwithopenreductionandplatefixationscrews,fracturehealingtimewas80to102days.In16childrenofdirectsurgicaltreatment,14childrenneededhealingtimeof80to160days,internal
7、fixationwasremovedin7to12months;1childresultedintheforearmmusclesintervalsyndromedecompressionforalongtimeafterinjury,andhadtounderwentfixationwithKirschnerwireanddelayskingraft,thefracturewashealedafter6months;1childhadulnanonunionandneededre-operationfromthenewinte
8、rnalfixationwithbonegraft,andthefracturewashealedafter1year.Conclusion:Childrenforearmfracturereductionshouldbemanuallyreducedinear
