儿童Salter—Harris Ⅱ型指骨骨折的治疗  

Treatment of Salter-Harris type II phalangeal fracture in children

作　　者：柳权哲 孙鸿斌[1] 杨光[1] 倪晓威[1] 

机构地区：[1]吉林大学中日联谊医院手外科,长春130033

出　　处：《中华手外科杂志》2017年第5期340-342,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨闭合复位克氏针固定治疗儿童Salter-HarrisⅡ型指骨骨折的临床效果。方法自2014年1月至2016年3月，我们采取闭合复位经皮克氏针固定治疗儿童指骨骨折12例14指。术前经X线片确诊，骨折均有不同程度移位并根据骺板骨折的Salter-Harris分型，均为Ⅱ型。术后2、4、6周定期复查摄X线片观察骨折愈合情况。结果术后所有患儿均获得随访，时间为2-16个月，平均7个月。所有骨折均获得愈合，平均愈合时间为3.5周。愈后外观无明显成角和旋转畸形，无克氏针断裂、松脱及针道感染等并发症发生。疼痛按视觉模拟评分法（visual analogue scale，VAS）评分均为优。功能情况按中华医学会手外科学会上肢部分功能评定试用标准评定：优10例11指，良2例3指。结论在掌握适应证的前提下，采取闭合复位克氏针固定治疗伴有成角移位的儿童Salter-Harris Ⅱ型指骨骨折，能获得较满意的治疗效果。Objective To evaluate the clinical outcomes of closed reduction and Kirschner wire fixation in the treatment of Salter-Harris type Ⅱ phalangeal fracture in children. Methods From January 2014 to March 2016, 12 cases （14 fingers） of pediatric phalangeal fracture were treated by closed reduction and percutaneous Kirschner wire fixation. The preoperative X-ray showed that the fractures were displaced but not comminuted. According to the Salter-Harris classification, all the fractures were type Ⅱ . X-ray examination was performed at 2, 4 and 6 weeks after operation to observe fracture healing. Results All the patients were follow-up for 2 to 16 months with an average of 7 months. All the phalangeal fractures were healed with an average healing time of 3.5 weeks. There were no obvious angular or rotational deformities, no kirschner wire breakage or loosening and no pin infection. According to the visual analogue scale （VAS）, the pain scores were excellent. According to the functional evaluation standards issued by Hand Surgery Society of the Chinese Medical Association, the results were excellent in 10 cases （11 fingers）, good in 2 cases （3 fingers）. Conclusion Under the premise of mastering the indications, closed reduction and Kirschner wire fixation for the treatment of Salter-Harris type Ⅱ phalangeal fracture in children with angular displacement can achieve satisfactory results.

关 键 词：儿童 指骨 骨折固定术 Salter-Harris Ⅱ型 

分 类 号：R726.8[医药卫生—儿科]