微创双弹性髓内钉治疗儿童不稳定性桡骨下段骨折的疗效观察  

Treatment of unstable distal radius fractures in children with minimally invasive double elastic intramedullary nail

作　　者：钟志 黄小顺 何文江 林大鹏 ZHONG Zhi;HUANG Xiao-shun;HE Wen-jiang(Department of orthopaedics,Meizhou Hospital of traditional Chinese Medicine,Meizhou 514071,China)

机构地区：[1]梅州市中医医院二骨科,广东梅州514071

出　　处：《吉林医学》2018年第7期1223-1226,共4页Jilin Medical Journal

基　　金：梅州市科技计划项目[项目编号:2016B047]

摘　　要：目的:探讨微创双弹性髓内钉对儿童不稳定性桡骨下段骨折的临床治疗效果。方法:选择诊断为不稳定性桡骨下段骨折患儿124例,采用随机数字法将所有患儿平均分为观察组62例和对照组62例,观察组患儿采用微创双弹性髓内钉法治疗,对照组患儿采用常规切开复位钢板内固定法治疗,对比观察两组患儿的手术时间、术中失血量、手术费用以及骨折愈合时间等指标,对所有患儿进行12个月的随访,对比两组患儿骨折不愈合、骨桥形成、骨髓炎、桡神经损伤以及再骨折等并发症发生情况,并根据患儿复查时X线检查结果,采用Flynn髓内钉疗效评估标准对患儿骨折愈合情况进行评价,同时采用Gartland和Werley腕关节评分对患儿的腕功能进行评价。结果:观察组患儿的手术时间和术中出血量均明显低于对照组患儿,但手术费用显著高于对照组患儿,差异均具有统计学意义(P<0.05)。两组患儿的骨折愈合时间比较差异无统计学意义(P>0.05)。观察组患儿术后并发症总发生率为4.8%,对照组患儿术后并发症总发生率为6.5%,两组患儿并发症发生率比较差异无统计学意义(P>0.05)。两组患儿的术后愈合情况以及恢复后的腕功能评价比较,差异均无统计学意义(P>0.05)。但观察组患儿的治疗优秀率显著高于对照组患儿,差异具有统计学意义(P<0.05)。结论:微创双弹性髓内钉对不稳定性桡骨下段骨折患儿的治疗效果理想,虽然使用双弹性髓内钉会增加患儿家庭的经济负担,但其具有创伤小、手术时间短、出血量小等优势,且术后并发症少,有利于患儿愈合,是不稳定性桡骨下段骨折患儿新的理想治疗方案。Objective To investigate the clinical effect of minimally invasive double elastic intramedullary nail in the treatment of unstable distal radius fractures in children. Method 124 children with unstable distal radius fractures were treated in our hospital,all the children were divided into observation group（ 62 cases） and control group（ 62 cases） by random number method,the observation group was treated with minimally invasive double elastic intramedullary nail method,while the control group was treated with conventional open reduction and plate fixation,the operation time,blood loss,operation cost and fracture healing time of the two groups were observed and compared,all children were followed up for 12 months,the complications of nonunion,bone bridge formation,osteomyelitis,radial nerve injury and re fracture were compared between the two groups,according to the X-ray examination results were checked,the curative effect evaluation standard of Flynn intramedullary nail on fracture healing were evaluated at the same time,using Gartland and Werley wrist score of patients with wrist function evaluation. Results The amount of bleeding and operation time in the observation group were significantly lower than that in the control group,but the cost of surgery was significantly higher than that in control group,the differences were statistically significant（ P〈0. 05）,two groups of children with fracture healing time was no significant difference（ P〉0. 05）,the observation group with postoperative complication rate was 4. 8%. The control group were the postoperative complication rate was 6. 5%. The complication rate of two groups of children had no significant difference（ P〉0. 05）; two groups were compared with the postoperative healing and recovery of wrist function evaluation,there were no significant differences（ P〉0. 05）,but the observation group with the excellent rate of treatment was significantly higher than the control group children. The difference was statistically significant（

关 键 词：桡骨下段骨折 不稳定 双弹性髓内钉 儿童 

分 类 号：R726.8[医药卫生—儿科]