儿童肱骨干骨折逆行与顺行弹性髓内针固定的疗效研究  

Comparative Analysis of Anterograde and Retrograde Approaches of Elastic Stable Intramedullary Nail Intreatment of Humeral Shaft Fractures in Children

作　　者：乔飞 蒋飞 QIAO Fei;JIANG Fei(Department of Pediatric Orthopedics,Affiliated Municipal Children’s Hospital of Dalian Medical University,Dalian 116012,Liaoning Province,China)

机构地区：[1]大连医科大学附属大连市儿童医院小儿骨科,辽宁大连116012

出　　处：《中国实用乡村医生杂志》2019年第4期63-66,共4页Chinese Practical Journal of Rural Doctor

基　　金：大连市医学科学研究计划项目,项目编号:1711063.

摘　　要：目的比较逆行进针与顺行进针不同入路ESIN治疗儿童肱骨干骨折的临床效果。方法回顾性分析2011年1月—2015年12月大连市儿童医院使用ESIN治疗的32例儿童肱骨干骨折的临床资料,并对顺行组和逆行组患儿手术时间、骨折愈合时间及肩、肘关节功能和并发症进行比较。结果手术时间:逆行组(45.3±13.1)min、顺行组(38.1±12.2)min,差异无统计学意义(t=11.43,P>0.05)。术后骨折成角:逆行组(7.4±1.2)°、顺行组(9.1±2.2)°,差异无统计学意义(t=6.12,P>0.05)。骨折愈合时间:逆行组(8.1±2.3)周、顺行组(8.6±1.5)周,差异无统计学意义(t=9.44,P>0.05)。术后肩关节功能和肘关节功能评分两组差异均无统计学意义(P>0.05)。两组均无感染、无医源性神经血管损伤、患肢畸形、功能障碍等并发症发生,但逆行组有5例出现针尾皮肤激惹反应。结论两种不同入路ESIN内固定治疗儿童肱骨干骨折均可获得满意疗效,逆行交叉固定骨折的并发症发生率较顺行高。Objective To compare the clinical outcomes of anterograde and retrograde approaches of elastic stable intramedullary nail(ESIN)intreatment of humeral shaft fractures in children. Methods The clinical data of 32 children with humeral shaft fracture treated with ESIN from January 2011 to December 2015 were retrospectively analyzed. The operation time, fracture healing time, shoulder and elbow joint function and complications were compared between the two groups. Results Operationtime: There was no signifcant differences between retrograde group and anterograde group [(45.3±13.1) min vs (38.1±12.2) min,(t=11.43, P>0.05)]. Postoperative fracture angulation: there was no significant difference between retrograde group and anterograde group [(7.4±1.2)°vs (9.1±2.2)°,(t=6.12, P>0.05)]. Fracture healing time: there was no signifcant difference between retrograde group and anterograde group [(8.1±2.3) weeks vs (8.6±1.5 weeks),(t=9.44, P>0.05)]. There was no signifcant difference in shoulder function and elbow function score between the two groups (P>0.05). There were no complications such as infection, iatrogenic neurovascular injury, limb deformity and dysfunction in both groups, but there were 5 cases of needle tail skin irritation in retrograde group. Conclusion the treatment of humeral shaft fractures with ESIN in children, the satisfactory outcome are similar in twogroups. The complication of bilateral retrograde group was more than anterograde group.

关 键 词：肱骨骨折 儿童 弹性髓内针 

分 类 号：R726.8[医药卫生—儿科]