闭合复位弹性髓内钉固定与切开克氏针治疗儿童桡骨颈骨折的效果分析  

Analysis on the effect of closed reduction with elastic intramedullary nail fixation and open kirschner wire in the treatment of radial neck fracture in children

作　　者：孟庆鑫[1] 王军[1] 刘滨 郭欣[1] MENG Qingxin;WANG Jun;LIU Bin;GUO Xin(Department of Orthopedics,the 6th Division Hospital of Xinjiang Production and Construction Corps,Xinjiang,831300,China)

机构地区：[1]新疆生产建设兵团第六师医院骨科

出　　处：《新疆医学》2019年第11期1115-1118,共4页Xinjiang Medical Journal

摘　　要：目的探讨闭合复位弹性髓内钉与切开复位内固定治疗儿童桡骨颈骨折的临床效果。方法自2010年8月-2018年1月,本院对52例儿童桡骨颈骨折进行治疗,其中切开复位克氏针固定组22人,闭合复位弹性髓内针固定组患者30例,按Metaizeau-Judet改良分型,Ⅲ型29例,Ⅳ型23例,男性31例,女性21例,年龄(5~13)岁,平均年龄9.1岁。通过术后肘关节屈伸、旋前旋后功能与健侧进行对比。结果本组随访时间在12个月~30个月不等,平均随访时限为14个月。骨折愈合时间平均(5.2±1.2)周(4~8周)。30例闭合复位弹性髓内钉患儿中,仅有2例有皮肤软组织激惹,其他患者均无并发症。根据Metaizeau系统评分标准统计优秀率为93.3%,其中优24例,良4例,可2例。术后肘关节屈伸、旋前旋后程度并与健侧行统计分析(P<0.05)为差异无统计学意义。切开复位克氏针内固定组,1例出现肘关节屈曲位融合,根据Metaizeau系统评分标准统计优秀率为63.6%,其中优8例,良6例,可7例,差1例。术后肘关节屈伸、旋前旋后程度并与健侧行统计分析(P>0.05)为差异有统计学意义。组间比较差异有统计学意义(Z=3.435,P=0.001)。结论与传统切开复位克氏针内固定相比较,闭合复位弹性髓内针固定,具有微创、固定稳定、操作简便、术后允许早期锻炼,并发症少等优点,是一种较好的治疗方法。Objective To investigate the clinical effect of closed reduction elastic intramedullary nail and open reduction and internal fixation on children with radial neck fracture.Methods From August 2010 to January 2018,52 children with radial neck fracture were treated in our hospital.Among them,Among them,there were 22 patients in the open reduction kirschner wire fixation group and 30 patients in the closed reduction elastic intramedullary wire fixation group.According to Metaizeau-improved Judet classification,29 cases were typeⅢ,23 cases were belonging to type s.Male patients were 31 cases,while female cases were 21 cases.All patients were from 5 to13 years old,and the average age was 9.1 years old.The function of elbow joint flexion and extension,pronation and pronation before and after operation were statistically analyzed.Results The follow-up time ranged from 12 to 30 months,and the average follow-up time was14 months.The mean time of fracture healing was(5.2±1.2)weeks(4~8 weeks).Among the 30 children being treated with closed reduction elastic intramedullary nailing,only 2 cases had skin and soft tissue irritation,while the other patients had no complications.According to the score standard of Metaizeau system,the rate of excellence was 93.3%.The degree of elbow joint flexion and extension,pronation and pronation before and after operation were statistically compared with the healthy side.The difference was not statistically significant(P<0.05).In the open reduction kirschner wire internal fixation group,1 case got elbow flexion fusion.According to the Metaizeau system scoring standard,the excellent rate was 63.6%,among which there were 8 excellent cases,6 good cases,7 average cases and 1 poor case.The degree of elbow joint flexion and extension,pronation and pronation before and after operation were statistically compared with the healthy side,and the difference was statistically significant(P>0.05).The difference between two groups was statistically significant(Z=3.435,P=0.001).Conclusion Compared with tr

关 键 词：桡骨颈骨折 弹性髓内针 儿童 

分 类 号：R683.42[医药卫生—骨科学]