弹性髓内钉与克氏针固定治疗儿童桡骨颈骨折的临床对比  

Clinical Comparison of Elastic Intramedullary Nail and Kirschner Wire Fixation for Treatment of Radius Neck Fracture in Children

作　　者：杨大兴 单延具 张琰 张欣亮 Yang Daxing;Shan Yanju;Zhang Yan(Department of Pediatric Orthopaedics,Beijing Chaoyang Emergency Mecical Center,Chaoyang District,Beijing100023,China)

机构地区：[1]北京朝阳急诊抢救中心小儿骨科

出　　处：《实用骨科杂志》2019年第11期961-964,共4页Journal of Practical Orthopaedics

基　　金：首都医学发展科研基金(2016-3713)

摘　　要：目的研究弹性髓内钉与克氏针固定治疗O’BrienⅡ、Ⅲ型儿童桡骨颈骨折的临床效果。方法回顾性分析本院2014年6月至2017年5月122例O’BrienⅡ、Ⅲ型桡骨颈骨折患儿病例资料,根据术中固定方式进行分组,60例进行弹性髓内钉固定的患儿分为对照组,其中男34例,女26例;年龄5~13岁,平均(7.8±1.4)岁;O’BrienⅡ桡骨颈骨折41例,Ⅲ型桡骨颈骨折19例。62例行克氏针固定的患儿为研究组,其中男35例,女27例;年龄6~12岁,平均(8.2±1.5)岁;O’BrienⅡ桡骨颈骨折39例,Ⅲ型桡骨颈骨折23例。比较两组手术情况、复位情况、Mayo肘关节功能评分。结果对照组的手术时间、住院时间显著高于研究组,差异有统计学意义(P<0.05);两组的术中出血量、骨折愈合时间比较,差异无统计学意义(P>0.05)。对照组复位优者46例,良者10例,中者4例;研究组复位优者50例,良者9例,中者3例;两组比较差异无统计学意义(P>0.05)。两组的疼痛、运动功能、稳定性、日常活动评分及Mayo肘关节功能总分比较,差异均无统计学意义(P>0.05)。结论弹性髓内钉与克氏针固定治疗O’BrienⅡ、Ⅲ型儿童桡骨颈骨折均能获得较好的临床疗效,恢复患儿的肘关节功能,但克氏针固定治疗的手术时间及住院时间更短。Objective To study the clinic effect of elastic intramedullary nail and kirschner wire fixation for treatment ofradiusneck fracture in children with O’BrienⅡandⅢ.Methods Thedata of 122 children data with O’BrienⅡandⅢradius neck fractures from June 2014 to May 2017 were retrospectively analyzed.According to the fixation method,60 children with elastic intramedullary nailing were set as the control group,including 34 males and 26 females;aged 5~13 years,mean(7.8±1.4)years;41 cases O’BrienⅡtibia neck fractures and 19 cases typeⅢof radial neck fracture.62 children with Kirschner wire fixation were set as the study group,including 35 males and 27 females;aged 6~12 years,mean(8.2±1.5)years old;39 cases of O’BrienⅡradial neck fracture and 23 cases typeⅢtibia of neck fracture.The surgery situation,reduction situation,and Mayo elbow function scores between the two groups were compared.Results The operation time and hospitalization time of the control group were significantly higher than that of the study group,and the differences were statistically significant(P<0.05).There was no significant difference in intraoperative blood loss and fracture healing time between the two groups(P>0.05).In the control group,there were46 patients with excellentreduction,10 good,4 mean,and nopoor reduction.The study group had 50 patients with excellent reduction,9 good,3 middle,and 0 poor results.There was no statistical significance(P>0.05).There were no significant differences in pain,motor function,stability,daily activity scores,and Mayo elbow joint function total scores between the two groups(P>0.05).Conclusion Elastic intramedullary nail and Kirschner wire fixation for O’Brien typeⅡandⅢchildren with radius neck fractures can achieve good clinical results and restore the elbow joint function of children.However,the operation time and hospitalization time of Kirschner wire fixation treatment are shorter.

关 键 词：弹性髓内钉 克氏针 O’BrienⅡ、Ⅲ型桡骨颈骨折 儿童 

分 类 号：R683.41[医药卫生—骨科学]