儿童前臂远端骨折的治疗选择  

Treatment of distal forearm fracture in children

作　　者：王儒法[1] 林刚[1] 楼跃[1] 唐凯[1] 张志群[1] 孙祥水[1] 

机构地区：[1]南京医科大学附属南京儿童医院骨科,210008

出　　处：《中华小儿外科杂志》2014年第1期15-19,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的评价不同治疗方法治疗儿童前臂远端骨折的原则、可行性及疗效。方法选取2007年至2010年收治的儿童前臂远端骨折110例，临床资料完整，其中闭合复位外固定42例（A组），闭合复位经皮克氏针固定18例（B组），切开复位内固定50例（C组）。根据Bohm复位评价标准，个体化治疗，随访2～5年按Berton愈后评价标准评价。结果A组中1例患儿石膏固定1周后骨折发生移位，重新塑形石膏；1例患儿石膏固定2周后骨折发生移位，后行二次复位固定。C组中有2例发生再骨折，均行二次切开复位克氏针内固定。末次随访时，优93例，良12例，可5例，差0例。三组的愈后比较，差异无统计学意义（P〉0．05）；三组骨折类型分布与治疗方式的关联性分析，差异有统计学意义（P〈0．05）。结论儿童前臂远端骨折常见，塑形能力强，愈后好，但不同类型的骨折治疗原则不尽相同，提倡个体化治疗。Objective To present the principle, efficacy and feasibility of different methods in managing of distal forearm fracture in children. Methods From 2007 to 2010,110 patients with distal forearm fractures were retrospectively reviewed. We categorized the patients into 3 groups： group A （42 patients） underwent closed reduction and cast immobilization, group B（18 cases） underwent closed reduction and pin fixation, and group C （50 cases） underwent open reduction. All patients received individualized treatment according to Bohm＇s criteria. All cases were followed up for 2 to 5 years by Berton＇s criteria. Results In group A, one suffered redisplacement of fractures one week after closed reduction and needed piaster re-moulding, and the other one suffered redisplacement two weeks after dosed reduction and needed remanipulation and Kirschner wiring. In group C, 2 cases suffered refracture and needed reduction and Kirschner wires fixation. At the end of follow-up, the results were excellent in 93 cases, good in 12 cases, and acceptable in 5 eases, without any unacceptable results. There were no differences of prognosis among three groups; however, the distribution of fracture patterns was significantly associated with treatment modalities. Conclusions Distal forearm fractures are extremely common with satisfactory remodeling and excellent functional recovery. However, therapeutic principles vary in different types of fractures, and individualized treatment is advocated.

关 键 词：桡骨骨折 骨折固定术 克氏针 

分 类 号：R726.8[医药卫生—儿科]