小儿MasonⅡ型桡骨头颈部骨折的修复  

REPAIR OF MASON TYPE-II RADIAL HEAD OR NECK FRACTURES IN CHILDREN

作　　者：王道喜[1] 唐学阳[1] 蒋欣[1] 陈小亮[1] 刘利君[1] 

机构地区：[1]四川大学华西医院小儿外科,四川成都610041

出　　处：《中国修复重建外科杂志》2010年第4期435-437,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结采用手术开放复位、克氏针内固定治疗小儿MasonⅡ型桡骨头颈骨折的临床疗效。方法2007年9月-2009年6月,采用手术开放复位、克氏针内固定治疗小儿桡骨头颈骨折17例。其中男11例,女6例;年龄4～11岁,平均8.5岁。左侧5例,右侧12例。均为跌伤所致。骨折按Mason分型均为Ⅱ型。伴桡神经深支损伤2例。伤后至手术时间4h～5d。结果术后患儿伤口均Ⅰ期愈合。按照Métaizeau标准评定手术复位情况,良好15例,较好2例;均达到解剖复位或接近解剖复位。17例均获随访,随访时间6～25个月,平均14个月。2例桡神经损伤患儿术后6个月功能恢复正常。术后无关节感染、神经损伤等并发症。术后复查X线片示骨折均获骨性愈合,愈合时间2.0～3.5个月,平均3.0个月。术后6个月采用Broberg等肘关节功能评分法评定肘关节功能,获优11例,良4例,可2例,优良率88.2%。结论手术开放复位、克氏针内固定治疗小儿MasonⅡ型桡骨头颈骨折疗效可靠,功能恢复好,并发症少。Objective To investigate the curative effects of open reduction and internal fixation with Kirschner wire for Mason type-II radial head or neck fracture in children.Methods From September 2007 to June 2009,17 cases of Mason type-II radial head or neck fracture were treated,including 11 males and 6 femals with an average age of 8.5 years（4-11 years）.The locations were left side in 5 cases and right side in 12 cases.All fractures were caused by falling and classified as Mason typeII fracture.Two cases complicated by radial nerve deep branch injury.The time from injury to operation was 4 hours to 5 days.All cases received open reduction and internal fixation with Kirschner wire.They were evaluated by anteroposterior and lateral radiographs and functionally by Broberg criteria.Results Wound healed primarily in all patients.According to Métaizeau criteria,the results were excellent in 15 patients and good in 2 patients,who achieved anatomical reduction.Seventeen patients were followed up for a mean time of 14 months（6-25 months）.Function returned to normal in 2 cases complicated by radial nerve deep branch injury after 6 months of operation.No complications of infection and nerve injury occurred.The X-ray films showed that bony healing was achieved in all cases;the healling time was 2.0-3.5 months（mean 3 months）.According to Broberg criteria,the outcome was excellent in 11 cases,good in 4 cases,and fair in 2 cases,the excellent and good rate was 88.2%.Conclusion Open reduction and internal fixation with Kirschner wire has good effect,satisfactory functional recovery and less complication in the treatment of Mason type-II fracture of radial head or neck in children.

关 键 词：桡骨头颈骨折 克氏针 内固定 儿童 

分 类 号：R726.8[医药卫生—儿科]