弹性髓内钉治疗大龄儿童锁骨骨折的临床疗效  

Therapeutic effects of titanium elastic nails for the treatment of clavicular fractures in elder children

作　　者：许国军[1] 吴国林[1] 陈旭宏[1] 季向荣[1] 黄洪斌[1] 陈超丽[1] 

机构地区：[1]温州医科大学附属义乌医院骨科,浙江义乌322000

出　　处：《中国骨伤》2015年第2期101-105,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：研究弹性髓内钉闭合复位治疗大龄儿童锁骨骨折的应用和疗效。方法 ：自2010年10月至2012年12月,应用弹性髓内钉治疗16例大龄儿童锁骨骨折患者,男9例,女7例;年龄9-17岁,平均14.2岁;受伤至手术时间2-6 d。骨折类型：横形骨折13例,斜形3例（无长斜形骨折）。分别比较健侧与患侧术后3个月随访时的肩关节Neer评分和术后3周的肩关节活动度,并通过X线片检查随访患者骨折愈合及复位情况。结果 ：术后患儿伤口愈合良好,术后有2例出现皮肤激惹反应,没有出现感染、TEN断裂、骨折延迟愈合及顶破皮肤等并发症。所有患儿获得随访,时间3-10个月,平均7.2个月。术后3个月Neer评分96.69±6.22,与健侧98.75±2.70比较,差异无统计学意义（t=2.12,P〉0.05）。术后3周肩关节活动度与健侧比较差异有统计学意义（P〈0.05）。术后12-18周X线片显示骨性愈合后取出髓内钉,术后肩关节活动度恢复良好。结论：弹性髓内钉具有损伤小、美观、固定可靠等优点,可为大龄儿童锁骨骨折提供一种较为理想的内固定方法。Objective：To research the application and clinical effect of titanium elastic nails（TEN） for the treatment of closed clavicular fracture in elder children. Methods：From October 2010 to December 2012,16 elderly children with clavicular fracture of elder children were treated with internal fixation,including 9 boys and 7 girls with an average age of 14.2 years old ranging from 9 to 17 years. The mean time between injury and surgery was 2 to 6 days. Thirteen patients had a transverse fractures; 3 patients had a oblique fractures,excluding the long oblique patients. Neer function score after 3 months follow up and the shoulder activity degree after 3 weeks followed were compared respectively between the injured side and healthy side.Fracture reduction and healing were followed up by X rays to analyze internal fixation with TEN technique. Results：All patients were healed well after surgery. There were 2 cases with soft tissue irritation. No cases of infection,TEN broken,delayed healing or skin bursting were observed. All patients were followed up for 3 to 10 months,with an average of 7.2 months. There were no significant differences（t=2.12,P〉0.05） between the healthy side（98.75±2.70） and injured side（96.69±6.22）of Neer score at 3 months during followed up. The shoulder activity at 3 weeks during followed up was different between both sides（P〈0.05）. The intramedullary nail was removed after X rays at 12-18 weeks during followed up showed good bone healing,and the shoulder function was recovered well. Conclusion：Internal fixation with TEN for the treatment of clavicular fracture has advantages of a limited invasion,beauty,safety and reliability. This technique provides an ideal fixation option for the treatment of clavicular fracture in elder children.

关 键 词：锁骨 骨折 儿童 骨折固定术 髓内 外科手术 

分 类 号：R683.410.5[医药卫生—骨科学]