顺行弹性髓内针与克氏针治疗儿童桡骨干与干骺端交界区骨折的对比研究  

A comparative study of anterograde elastic intramedullary needling versus Kirschmann wiring for radial trunk and metaphyseal junction fractures in children

作　　者：石佳宁 张琳[1] 周显军 段于河[1] 英庆龙 邢茂青 李富江[1] Shi Jianing;Zhang Lin;Zhou Xianjun;Duan Yuhe;Ying Qinglong;Xiong Maoqing;Li Fujiang(Department of Pediatric Surgery,Affiliated Hospital,College of Medicine,Qingdao University,Qingdao 266400,China)

机构地区：[1]青岛大学医学院附属医院小儿外科,青岛266400

出　　处：《临床小儿外科杂志》2023年第9期866-870,共5页Journal of Clinical Pediatric Surgery

摘　　要：目的对比顺行弹性髓内针与传统克氏针治疗儿童桡骨干与干骺端交界区骨折的临床疗效。方法回顾性分析青岛大学医学院附属医院自2019年1月至2022年1月收治的50例桡骨远端骨干与干骺端交界区骨折患儿临床资料,根据手术方式的不同分为顺行弹性髓内针组(17例)及克氏针组(33例)。临床资料包括性别、年龄、是否合并尺骨远端骨折、手术时间、术后2周骨折成角、对位情况。随访资料包括外固定时间、术后3个月腕关节活动度、腕关节功能优良率、肘关节功能优良率及并发症。结果顺行弹性髓内针组手术时间长于克氏针组[(81.8±38.4)min比(59.4±26.1)min],差异无统计学意义(P>0.05);术后2周骨折平均对位率大于克氏针组(92%比88%),差异无统计学意义(P>0.05);拆除石膏外固定时间短于克氏针组[(31.5±5.1)d比(39.0±9.2)d],差异有统计学意义(P<0.05);术后3个月腕关节活动度指标高于克氏针组,差异有统计学意义(P<0.05);术后3个月腕关节恢复优良率高于克氏针组(94.12%比66.67%),差异有统计学意义(P<0.05);术后3个月肘关节恢复优良率低于克氏针组(82.35%比87.88%),差异无统计学意义(P>0.05)。结论儿童桡骨远端骨干与干骺端交界区骨折采用顺行弹性髓内针治疗较传统克氏针治疗的临床效果好,可有效缩短术后拆除石膏外固定时间,有利于术后腕关节活动恢复,是治疗儿童桡骨远端骨干与干骺端交界区骨折的一种可选手术方法,具有临床推广价值。Objective To compare the clinical efficacy and application value of a novel operative approach of anterograde elastic intramedullary needling versus traditional Kirschmann wiring for junction fractures of radius trunk and metaphyseal in children.Methods Retrospective analysis was performed for 50 children with fractures at junction of distal radial diaphysis and metaphysis from January 2019 to January 2022.They were assigned into two groups of anterograde elastic intramedullary acupuncture(n=17)and Kirschmann acupuncture(n=33)according to different surgical approaches.The relevant clinical data included gender,age,concurrent distal ulnar fracture,operative duration,fracture angulation and alignment status at Week 2 post-operation.Duration of external fixation,wrist motion,good/excellent rate of wrist function,good/excellent rate of elbow function and complications were recorded at Month 3 post-operation.Results Operative duration was longer in anterograde elastic intramedullary acupuncture group than that in Kirschner's needle group[(81.8±38.4)vs.(59.4±26.1)min]and the difference was not statistically significant(P>0.05).The mean contraction of fractures was higher in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intramedullary acupuncture Kirschner's needle group(92%vs.88%)and the difference was not statistically significant(P>0.05).The removal time of external plaster fixation was shorter in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture Kirschner's needle group[(31.5±5.1)vs.(39.0±9.2)day]and the difference was statistically significant(P<0.05).The wrist range of motion was higher in anterograde elastic intramedullary acupuncture anterograde elastic intramedullary acupuncture group than that in anterograde elastic intr

关 键 词：骨折固定术 髓内 桡骨骨折 外科手术 儿童 

分 类 号：R726.8[医药卫生—儿科]