弹性髓内针治疗儿童桡骨颈骨折的临床应用研究  

Clinical application of elastic stable intramedullary nail in treatment of radial neck fractures

作　　者：李兵[1] 张军[1] 张亚军[1] 

机构地区：[1]武警北京总队第二医院骨科,100037

出　　处：《中华肩肘外科电子杂志》2014年第2期97-102,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的探讨弹性髓内针治疗桡骨颈骨折疗效。方法我院于2006年5月至2009年9月应用弹性髓内针治疗23例桡骨颈骨折患者,其中男性17例,女性6例,年龄6~13岁,平均9.3岁。摔伤21例,绞伤2例。按 Judet 分型,其中Ⅱ型3例、Ⅲ型16例、Ⅳ型4例。合并肘关节其他部位损伤3例,其中肘关节内侧副韧带损伤2例,肱骨内上髁骨折1例。结果术后随访6~38个月,平均17.5个月。根据 Métaizeau 术后 X 线片评价标准,优18例、良3例、中2例,优良率达91%。功能评价采用 Métaizeau 功能评价标准,优16例、良6例、一般1例,优良率达96%。其中2例桡骨头骺变形膨大,1例出现关节周围异常钙化。结论弹性髓内针治疗桡骨颈骨折操作简便,效果满意。Background Radial neck fractures account for 5%-10% in elbow joint fractures and most of them are slightly displaced or non-displaced types.Satisfactory therapeutic results can be achieved by conservative treatment.As to severe displaced radial neck fractures,it is controversial in selection of therapeutic methods and curative effect clinically.To explore clinical therapeutic effect of radial neck fractures with elastic intramedullary nail and accumulate experience for diagnosis and treatment,23 cases of radial neck fracture were treated with elastic intramedullary nail from May 2006 to September 2009 in our hospital.Methods From May 2006 to September 2009,23 cases of radial neck fracture were admitted into our hospital and treated with elastic intramedullary nail,including 1 7 male and 6 female,aged from 6 to 13,and the average age was 9.3 years.Traumatic mechanisms were classified as fallen injuries with 21 cases and wringer injuries with 2 cases.Twenty cases were in right elbow and 3 cases were in left elbow.Operation time from injury ranged from 1 to 5 days,and averaged in 2.3 days.There were 3 cases of associated injuries on other parts of the elbow joint,including 2 cases of medial collateral ligament injury and 1 case of fracture of medial epicondyle of humerus.All patients were given X-ray and CT examinations after hospitalization.According to the severity of radial neck angular displacement and Judet classification system,3 patients were classified into type II,1 6 patients into type Ⅲ,and 4 patients into type IV.Close reduction and elastic intramedullary nail fixation:After successful anesthesia,the patient was in spine position with the affected limb abducted. The nail would be inserted from distal to proximal.The insertion site was just 1 to 2 cm proximal to the distal radial epiphyseal plate level.A small incision was made.The underlying tendons and superficial branch of radial nerve were well protected.An awl was used perpendicular to the lateral radius to open the cortex.And then proceeded the aw

关 键 词：弹性髓内针 骨折 桡骨颈 

分 类 号：R726.8[医药卫生—儿科]