儿童肱骨髁上骨折移位程度与Baumann角关系的分析研究

摘要

Objective:To analyze the relationship between the degree of displacement and Baumann angle in pediatric supracondylar humeral fractures by using Excel, and to guide treatment for humeral fractures of children. Methods: From July 2010 to July 2011 ,56 children with humeral supracondylar fractures were collected (34 boys and 22 girls ,15 patients with radial deviation and 41 patients with ulnar deviation,ranging in age from 3 to 14 years). The data of the patients about fracture displacement and the Baumann angle measured by MB-Ruler were input in Excel and then were analyzed to obtain data fitting curve. Results:There were close results between two methods,and the tangent of the radial deviation was more than tangent of ulnar deviation,which indicated that the influence of ulnar deviation was stronger than that of the radial deviation in pediatric supracondylar humeral fractures,so the correction should be paid attention to in clinic. When the radial deviation coefficient was less than-0.18 and ulnar deviation coefficient was more than 0.50,the Baumann angle would change to the reverse trend, so the angle range of Baumann in clinic should be between 65.70 and 96.77 degree. When the ulnar deviation factor was more than 0.15 (including 0.15) and Baumann angle more than 82 degrees (including 82 degree) ,cubitus varus deformity occurred inevitably, so the practices and surgical reduction should be focused on in clinic. Conclusion: According to data curves analysis results, the influence of ulnar deviation is stronger than that of the radial deviation in pediatric supracondylar humeral fractures. When the ulnar deviation factor is more than 0.15 (including 0.15) .correction should be focused on in order to prevent cubitus varus deformity.%目的:应用Excel软件对小儿肱骨髁上骨折的桡尺侧移位值和Baumann角进行数值拟合分析,得出相关数据曲线,以期用于指导临床小儿肱骨髁上骨折治疗.方法:收集2010年7月至2011年7月间就诊的小儿肱骨髁上骨折病例56例(年龄3～14岁；男34例,女22例；桡偏型15例,尺偏型41例).采用数据测量工具MB-Ruler,测量各病例X线片骨折的移位值及Baumann角,将数值录入于Excel,分别对56组骨折的移位值和Baumann角,以及15组桡偏型、41组尺偏型数值行拟合分析,并对所得数据曲线进行分析.结果:用2种方式进行拟合所得出结果相近,即尺偏切线斜率＞桡偏切线斜率；当桡偏系数＜-0.18,尺偏系数＞0.50时,Baumann角有反向改变的趋势,即Baumann角变化范围在65.70°～96.77°；当尺偏系数≥0.15时,Baumann角≥82°.结论:小儿肱骨髁上骨折尺偏移位对Baumann角的影响大于桡偏移位,当尺偏系数≥0.15时应注重纠正,预防肘内翻发生.