弹性髓内钉固定术对O’BrienⅡ、Ⅲ型儿童桡骨颈骨折预后及关节功能的影响  

Effect of Elastic Intramedullary Nailing on the Prognosis and Joint Function in Children with O＇Brien Ⅱ and Ⅲ Radial Neck Fractures

作　　者：叶卫华[1] 梅海波[1] 刘昆[1] 唐进[1] 伍江雁[1] 

机构地区：[1]湖南省儿童医院骨科,湖南长沙410007

出　　处：《医学临床研究》2017年第12期2326-2329,共4页Journal of Clinical Research

摘　　要：【目的】探究弹性髓内钉固定术对O’BrienⅡ、Ⅲ型儿童桡骨颈骨折预后及关节功能的影响。【方法】选取本院2014年3月至2016年3月收治的152例O’BrienⅡ、Ⅲ型桡骨颈骨折患儿，按照随机数表法分为观察组、对照组，各76例，分别实施弹性髓内钉固定术、切开复位克氏针内固定术治疗。记录两组患儿手术情况、术后并发症发生情况、骨折复位质量及关节功能恢复情况，比较两种术式的治疗效果、安全性以及对患儿预后的影响。【结果】观察组手术时间长于对照组，其切口长度短于对照组，差异有统计学意义（P〈0.05）。两组患儿术后并发症发生率均为3．95%，组间比较差异无统计学意义（P〉0.05）。术后12个月，观察组骨折复位优良率为93．42%，高于对照组的76．32%；其Meyo评分屈伸功能、关节稳定性、日常生活功能项目及总分均高于对照组，差异有统计学意义（P〈0.05）。【结论】弹性髓内钉固定术治疗O’BrienⅡ、Ⅲ型儿童桡骨颈骨折安全、可靠，较切开复位克氏针内固定术而言，其微创优势更为明显且在改善患儿预后及关节功能方面作用更为理想，值得推荐。[Objective]To explore the effect of elastic intramedullary nailing on the prognosis and joint function in children with O＇Brien Ⅱ and Ⅲ radial neck fractures. [MethodslA total of 152 children with O＇Brien type Ⅱ and Ⅲ radial neck fractures admitted to our hospital from March 2014 to March 2016 were randomly divided into the observation group and the control group, with 76 cases in each group. The elastic intramedullary nailing fixation was implemented in the observation group and Kirschner wire fixation was used in the control group. The operation procedure, the incidence of postoperative complications, the quality of fracture reduction and the recovery of joint function were recorded in the two groups. The efficacy, safety and prognosis of the two surgical procedures were compared.[Resuhs]The operation time of the observation group was longer than that of the control group, and the incision length was shorter than that of the control group; the difference was statistically significant （ P〈0.05）. The incidence of postoperative complications in the two groups was 3.95 %, and there was no significant difference between the two groups （ P 〉0.05）. At 12 months after surgery, the excellent rate of fracture reduction in the observation group was 93.42%, which was higher than that in the control group （76.32%）. Meyo score, flexion and extension function, joint stability, daily life function items and total score in the observation group were higher than those in the control group; the difference was statistically significant （ P 〈0.05）. [Conclusion]Elastic intramedullary nail fixation for the treatment of O＇Brien type of radial neck fractures in children is safe and reliable. Compared to the open reduction and internal fixation with Kirschner wire, its minimally invasive advantage is apparent. It helps improve the prognosis and joint function in children with radial neck fracture.

关 键 词：桡骨骨折/外科学 骨钉 骨折固定术 内 预后 

分 类 号：R683.415[医药卫生—骨科学]