Abstract:

Objective　To investigate the effect of continuous nursing intervention based on the Omaha system on children with supracondylar fracture of humerus. Methods　The clinical data of 88 children with supracondylar fracture of humerus admitted to the Children's Hospital Affiliated to Zhengzhou University from May 2022 to May 2024 were retrospectively selected. They were divided into a control group and an observation group, with 44 cases in each group, according to different nursing methods. In the control group, there were 24 boys and 20 girls, aged 6-12 (9.95±0.53) years; fracture sites: 19 cases on the left side and 25 cases on the right side; fracture classification: 10 cases of type II, 19 cases of type III, and 15 cases of type IV. In the observation group, there were 23 boys and 21 girls, aged 6-12 (9.92±0.56) years; fracture sites: 21 cases on the left side and 23 cases on the right side; fracture classification: 11 cases of type II, 20 cases of type III, and 13 cases of type IV. The control group received conventional nursing, while the observation group received continuous nursing intervention based on the Omaha system. Both groups were continuously followed up for 3 months. The exercise compliance, elbow joint range of motion, elbow joint recovery, and incidence of complications were compared between the two groups. Statistical analysis was performed using t-test and χ² test. Results　After nursing, the scores of the integrity of the exercise content, whether to master exercise methods, the frequency and duration of daily exercise, and the initiative of exercise of the exercise compliance in the observation group were (86.06±4.30) points, (84.42±3.94) points, (85.51±3.62) points, and (84.64±3.95) points, which were higher than those of the control group [(81.17±4.22) points, (78.83±3.35) points, (79.49±3.54) points, and (78.38±3.91) points] (t=5.384, 7.170, 7.887, and 7.471, all P<0.05); the flexion, extension, pronation, and supination ranges of motion of the elbow joint in the observation group were (132.87±6.69)°, (5.00±1.12)°, (82.57±3.71)°, and (81.18±3.92)°, which were greater than those in the control group [(126.87±6.61)°, (2.54±0.61)°, (74.99±3.68)°, and (76.64±3.53)°] (t=4.232, 12.795, 9.622, and 5.709; all P<0.05); the scores of motor function, pain, daily activity ability, and joint stability of the Mayo Elbow Function Scale (MEPS) in the observation group were (14.04±1.85) points, (28.53±1.79) points, (18.98±1.86) points, and (8.08±0.53) points, which were higher than those in the control group [(11.53±1.80) points, (22.92±1.65) points, (14.94±1.78) points, and (6.16±0.51) points] (t=6.450, 15.286, 10.409, and 17.315, all P<0.05). The total incidence of complications in the observation group was 4.55% (2/44), which was lower than 18.18% (8/44) in the control group (χ²=4.062, P=0.044). Conclusion　Continuous nursing intervention based on the Omaha system can improve the exercise compliance and elbow joint range of motion in children with supracondylar fracture of humerus, facilitate the recovery of elbow joint function, and also reduce the risk of complications.

Key words: Supracondylar fracture of humerus,  , Omaha system,  , Continuous nursing intervention,  , Exercise compliance,  , Postoperative recovery

摘要：

目的　探讨基于奥马哈系统的延续性护理干预在肱骨髁上骨折患儿中的应用效果。方法　回顾性选取郑州大学附属儿童医院2022年5月至2024年5月收治的88例肱骨髁上骨折患儿的临床资料，依照护理方式不同将其分为对照组和观察组各44例。对照组男24例，女20例；年龄6～12（9.95±0.53）岁；骨折部位：左侧19例，右侧25例；骨折分型：Ⅱ型10例，Ⅲ型19例，Ⅳ型15例。观察组男23例，女21例；年龄6～12（9.92±0.56）岁；骨折部位：左侧21例，右侧23例；骨折分型：Ⅱ型11例，Ⅲ型20例，Ⅳ型13例。对照组采取常规护理，观察组采取基于奥马哈系统的延续性护理干预，两组均持续护理随访3个月。比较两组患儿锻炼依从性、肘关节活动度、肘关节恢复情况、并发症发生率。采用t检验、χ2检验进行统计学分析。结果　护理后，观察组锻炼依从性中锻炼内容的完整性、是否掌握锻炼方法、每日锻炼的频次和持续时间、锻炼的主动性评分分别为（86.06±4.30）分、（84.42±3.94）分、（85.51±3.62）分、（84.64±3.95）分，均高于对照组的（81.17±4.22）分、（78.83±3.35）分、（79.49±3.54）分、（78.38±3.91）分（t=5.384、7.170、7.887、7.471，均P<0.05）；观察组肘关节屈曲、伸直、旋前、旋后活动度分别为（132.87±6.69）°、（5.00±1.12）°、（82.57±3.71）°、（81.18±3.92）°，均大于对照组的（126.87±6.61）°、（2.54±0.61）°、（74.99±3.68）°、（76.64±3.53）°（t=4.232、12.795、9.622、5.709，均P<0.05）；观察组Mayo肘关节功能评分量表（MEPS）中的运动功能、疼痛、日常活动能力、关节稳定性评分分别为（14.04±1.85）分、（28.53±1.79）分、（18.98±1.86）分、（8.08±0.53）分，均高于对照组的（11.53±1.80）分、（22.92±1.65）分、（14.94±1.78）分、（6.16±0.51）分（t=6.450、15.286、10.409、17.315，均P<0.05）。观察组并发症总发生率为4.55%（2/44），低于对照组的18.18%（8/44）（χ2=4.062，P=0.044）。结论　基于奥马哈系统的延续性护理干预可提升肱骨髁上骨折患儿的锻炼依从性和肘关节活动度，利于肘关节功能恢复，还可降低并发症发生风险。

关键词: 肱骨髁上骨折, 奥马哈系统, 延续性护理, 锻炼依从性, 术后恢复