儿童尺骨干骨折合并桡骨颈骨折的治疗  

Treatment of ulnar shaft fracture combined with radius neck fracture in children

作　　者：于铁强[1] 左玉明[1] 王月光[1] 廉小婧 李飞[1] 张磊[1] 万广亮 庞海涛[1] 王晶[1] 马建凤[1] YU Tie-qiang;ZUO Yu-ming;WANG Yue-guang;LIAN Xiao-jing;LI Fei;ZHANG Lei;WAN Guang-liang;PANG Hai-tao;WANG Jing;MA Jian-feng(Department of Pediatric Orthopaedics,the second Hospital of Tangshan.Tangshan,Hebei,063000,China)

机构地区：[1]唐山市第二医院小儿骨科

出　　处：《中国骨与关节杂志》2019年第10期771-774,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨儿童尺骨干骨折伴桡骨颈骨折(或桡骨近端骨骺损伤)的临床特点及治疗效果。方法回顾性分析2010年1月至2015年12月11例尺骨干骨折合并桡骨颈骨折(或桡骨近端骨骺损伤)患儿,其中男6例,女5例,年龄3~7岁,平均4.4岁。摔伤9例,1米高处摔下2例。左侧5例,右侧6例。尺骨骨折弹性钉或接骨板固定,桡骨颈骨折弹性钉和(或)克氏针固定。术后长臂石膏托固定3~4周,术后4~6个月取出弹性钉、接骨板。结果随访12~24个月,平均14个月。术后患儿切口均I期愈合,未发生骨筋膜室综合征、伤口感染等术后早期并发症。桡神经损伤在6周内恢复。采用改良的Flynn标准评价:11例优良。结论儿童尺骨干骨折合并桡骨颈骨折为1型类孟氏骨折的一种类型,尺骨多为斜行骨折,骨折线由后上至前下、外上至内下,骨折部位在中段或中上段,桡骨头多留在原位、远折端向前移位。手术先复位固定尺骨骨折、再复位固定桡骨颈骨折,效果良好。Objective To investigate features and treatment of ulnar shaft fracture combined with radius neck fracture(proximal radial epiphysis injury)in children.Methods From January 2010 to December 2015,11 patients of ulnar shaft fracture combined with radius neck fracture(proximal radial epiphysis injury)were analyzed retrospectively.There were 6 males and 5 females,with an average age of 4.4 years(range:3-7 years).Causes of injury:9 patients of falling injury,2 patients of falling at the height of 1 m.Five patients were injured on the left,while 6 on the right.Ulnar fracture was fixed with elastic nails or plates.Radial neck fracture was fixed with elastic nails and/or Kirschner wires.Long arm plaster cast had been applied for 3-4 weeks,and elastic nails and plates were removed 4-6 months after operation.Results All patients were followed up for 14 months on average(range:12-24 months).All incisions healed by the first intention without infection or osteofascial compartment syndrome.Radial nerve injury recovered within 6 weeks.All results were excellent according to modified Flynn’s system.Conclusions Ulnar shaft fracture combined with radius neck fracture is one of type 1 Monteggia-equivalent fractures,which are commonly oblique fractures.The fracture line is from posterior-upper to anterior-lower,lateral-upper to medial-lower.The fracture site is in the middle or middle-upper part,and the radial head is mostly left in situ and displaces at the distal end.Radial neck fracture reduction following ulna fracture reduction is effective.

关 键 词：尺骨骨折 桡骨骨折 骨骺 骨折固定术 儿童 

分 类 号：R726.8[医药卫生—儿科] R683[医药卫生—临床医学]