克氏针经皮撬拨复位联合Métaizeau法治疗儿童JudetⅣ型桡骨颈骨折  

Percutaneous Kirschner wire leverage reduction combined with M^taizeau＇s technique for treatment of children with Judet type Ⅳ radial neck fractures

作　　者：杜香平[1] 余丽蓉[1] 熊志刚[1] 陈干[1] 吴敏[1] 吴欣乐[1] 熊斌[1] 王保利[1] 

机构地区：[1]江西省儿童医院骨科,南昌330006

出　　处：《中华手外科杂志》2018年第1期10-12,共3页Chinese Journal of Hand Surgery

基　　金：江西省卫生计生委科技计划（20151134）

摘　　要：目的探讨2枚克氏针经皮撬拨复位联合Métaizeau法治疗儿童桡骨颈骨折的临床效果。方法自2013年1月至2016年6月应用2枚克氏针经皮撬拨复位联合Métaizeau法治疗儿童JudetⅣ型桡骨颈骨折16例：Ⅳa型8例，Ⅳb型8例。术后长臂前后石膏托固定3～4周，2～3个月拔除弹性髓内针。结果本组病例术后随访时间为12～39个月,平均19个月；骨折愈合时间4～10周，平均5.4周；未出现桡骨头缺血性坏死、桡骨近端骺板早闭、骨不连等并发症。术后X线片按Métaizeau标准评定：优12例，良4例；按MEPS肘关节功能评分标准评定：优10例，良5例，可1例。结论2枚克氏针经皮撬拨复位联合Métaizeau法治疗儿童JudetⅣ型桡骨颈骨折，可明显提高微创复位率，具有创伤小、并发症少、效果好、安全等优点。ObjectiveTo investigate the clinical effects of percutaneous two Kirschner wires leverage reduction combined with Métaizeau＇s technique in the treatment of children with Judet type IV radial neck fractures.MethodsFrom January 2013 to June 2016, 16 cases of Judet type IV radial neck fractures were treated by association of percutaneous two Kirschner wires leverage reduction and Métaizeau＇s technique. According to the Judet classification, 8 cases were type IV a and 8 cases were type IV b. After the operation, the affected arm was fixed using long arm plaster for 3 to 4 weeks. The elastic intramedullary nail was removed 2 to 3 months after the operation.ResultsAll the patients were follow-up for 12 to 39 months with an average of 19 months. Fracture healing time was 4 to 10 weeks with the average being 5.4 weeks. No complications such as avascular necrosis of the radial head, early closure of the epiphyseal plate of proximal radius and bone nonunion occurred. According to Métaizeau＇s standard, the postoperative X-ray was rated as excellent in 12 cases and good in 4 cases. According to the MEPS elbow function score, the results were excellent in 10 cases, good in 5 cases and fair in 1 case.ConclusionThe association of percutaneous two Kirschner wires leverage reduction and Métaizeau＇s technique in the treatment of children with Judet type IV radial neck fractures can significantly improve the rate of minimally invasive reduction, with advantages of less trauma, fewer complications, good effect and safety.

关 键 词：儿童 桡骨骨折 经皮复位 髓内针 

分 类 号：R726.8[医药卫生—儿科]