弹性髓内钉治疗儿童O'BrienⅢ型桡骨近端骨骺损伤的临床应用  

Treatment of proximal radius epiphyseal injuries of O'Brien type Ⅲ with titanium elastic nail in children

作　　者：董伊隆[1] 蔡春元[1] 张雷[1] 姜刚毅[1] 潘展鹏[1] 杨国敬[1] 

机构地区：[1]温州医学院附属第三医院骨科,浙江瑞安325200

出　　处：《中国骨伤》2012年第7期602-604,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨弹性髓内钉治疗儿童O'BrienIII型桡骨近端骨骺损伤的方法和临床疗效。方法:2008年10月至2009年11月,采用弹性髓内钉治疗19例儿童急性O'BrienIII型桡骨小头骨折,男13例,女6例;年龄6～12岁,平均8.3岁;伤后至手术时间平均3.5d(2～7d)。采用Métaizeau评定标准评定术后复位情况,采用Broberg-Morrey肘关节功能评分法评价肘关节功能。结果:所有患者获得随访,时间6～12个月,平均8.7个月。未出现感染、TEN断裂及顶破皮肤等并发症。术后Métaizeau评价结果,优7例,良10例,中2例。术后3个月Broberg-Morrey肘关节功能评分(86.6±6.3)分,较术前(47.3±5.1)分提高(t=139.17,P=0.0002);优7例,良9例,一般3例。结论:弹性髓内钉治疗儿童O'BrienⅢ型桡骨近端骨骺损伤具有疗效良好、创伤小、固定可靠等优点,为儿童O'BrienⅢ型桡骨近端骨骺损伤治疗提供一种可靠的选择。Objective： To investigate the feasibility and clinical effects of titanium elastic nail （TEN） for treatment of proximal radius epiphyseal injuries of O＇Brien type Ⅲ. Methods：From October 2008 to November 2009,19 patients with proximal radius epiphyseal injuries of O＇Brien type Ⅲ were treated with internal fixation ,including 13 males and 5 females with an average age of 8.3 years old ranging from 6 to 12 years. The average time from injury to surgery was 3.5 days （2 to 7 days）. The reduction situation after operation was assessed by Metaizeau criteria,and the elbow function after operation were evaluated by Broberg-Morrey elbow score. Results：All patients were followed-up for 8.7 months in average （ranged 6 to 12 months）. No infection,TEN brokage, skin bursting and other complications occurrenced. According to M6taizeau criteria,the results were excellent in 7 cases, good in 10 cases and fair in 2 cases. The Broberg-Morrey score rose from preoperative （47.3± 5.1 ） to （86.6±6.3） at 3 months followed-up （t=139.17, P=-0.0002） ; the outcome was excellent in 7 eases, good in 9 cases, and fair in 3 cases. Conclusion： Internal fixation with TEN in treatment of proximal radius epiphyseal injuries of OPBrien type III has a limited invasion,cosmetic beauty,safety and reliability advantages. This technique provides a reliable alternative in proximal radius epiphyseal injuries of O＇Brien type Ⅲ.

关 键 词：桡骨骨折 骨折固定术 内 儿童 

分 类 号：R683.41[医药卫生—骨科学]