【摘要】 目的:探讨儿童移位型肱骨髁上骨折致神经损伤类型、保守治疗时间和损伤机理。方法:对53例伴神经损伤的儿童移位型肱骨髁上骨折进行回顾性分析。结果:53例54条神经损伤涉及桡神经29条、骨间后神经13条、骨间前神经6条、正中神经4条、尺神经2条。46条神经保守治疗,8条神经手术探查连续性完整,呈牵拉和挤压伤,2条伴挫伤,伤后8～12周2条桡神经行松解术。伤后8～12周神经功能恢复48条,超过12周6条,最长时间24周。结论:儿童移位型肱骨髁上骨折所致的神经损伤,多数功能可自然恢复。伤后4～6周对神经恢复情况综合评定,肌电图神经传导速度测定功能无恢复及早手术,观察到伤后8～12周为宜。神经在肘部的临床解剖学特点是损伤的基础。更多还原

【Abstract】 Objective: To investigate the pattern, conservative time and clinical anatomy method of neural injuries resulting from displaced supracondylar fractures of the humerus in children. Method:A ret-rospectie review of neural injuries resulting from displaced supracondylar fractures of the humerus in 53 children were performed. Result:there were 54 associated neural injuries in 53 patients. 29 radial nerves, 13 posterior interosseous nerves, 6 anterior interosseous nerves, 4 median and 2 ulanr nerves were encountered. 46 neurological deficit was treated expectantly. 8 neurological deficit was treated by exploration and found to be in continuity.it was found to be stretch and extrusion,two of them also be contusion-Neuroly-sis was performed on two of radial nerves at 8 to 12 weeks after injury. 48 children had functional recovery at 8 to 12 weeks after injury and 6 over 12 weeks,the longest recovery time was 24 weeks. Conclusion;This study demonstrated that nerological deficit from displaced supracondylar fractures of the hmuerus in children involve all three major nerves of forearm and posterior and anterior interosseous nerves,with rare exception, recover with conservative therapy. If there is no clinical or a nerve-conduction velocity and elec-tromygraphic evidence of return of neural function at 4 to 6 weeks after injury,exploration and neurolysis should be performed-The clinical anatomy property of the nerve in elbow is fundamental cause of injury.更多还原