两种手术方法治疗儿童桡骨远段1/3处骨折  

Two surgical methods in the treatment of distal 1/3 fracture of the humerus in children

作　　者：呼和[1] 蒋飞[1] 侯利民 乔飞[1] 姬广春[1] HU He;JIANG Fei;HOU Li-min;QIAO Fei;JI Guang-chun(Dept of Orthopaedics,Dalian Children′s Hospital,Dalian,Liaoning 116012,China)

机构地区：[1]大连市儿童医院骨科,辽宁大连116012

出　　处：《临床骨科杂志》2020年第3期384-386,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较闭合复位弹性髓内针与闭合复位克氏针交叉固定治疗儿童桡骨远段1/3处骨折的临床疗效。方法将92例桡骨远段1/3处骨折患儿随机分为髓内针固定组(46例)和克氏针交叉固定组(46例),比较两组患儿的手术情况、腕关节活动度、并发症及Garland-Werley腕关节功能评分优良率。结果92例患儿均获得随访,时间6~12个月。手术时间和术后拆除石膏时间髓内针固定组均短于克氏针交叉固定组(P<0.05)。术后3个月,患儿腕关节活动度(掌屈、背伸、桡偏、尺偏)髓内针固定组均大于克氏针交叉固定组(P<0.05)。末次随访时Garland-Werley腕关节功能评分优良率髓内针固定组高于克氏针交叉固定组(P<0.05)。两组患儿并发症发生率比较差异无统计学意义(P>0.05)。结论治疗儿童桡骨远段1/3处骨折,闭合复位弹性髓内针固定优于闭合复位克氏针交叉固定。Objective To compare the clinical efficacy of closed reduction elastic intramedullary nail with closed reduction and Kirschner wire cross fixation for treatment of distal 1/3 fracture of the humerus in children.Methods The 92 children with distal 1/3 fracture of the humerus were randomly divided into 46 cases of elastic intramedullary nail fixation group and 46 cases of Kirschner wire cross fixation group.Surgical conditions,wrist mobility,complications and the excellent-good rate of Garland-Werley wrist function scores were compared between the two groups.Results All 92 children were followed up for 6~12 months.The operation time and post removal time of the plaster with elastic intramedullary nail fixation group were shorter than those of the Kirschner wire cross fixation group(P<0.05).At 3 months after operation,children′s wrist functional activity(palm flexion,back extension,radial deviation,and ulnar deviation)was larger in the intramedullary nail fixation group than the Kirschner wire cross fixation group(P<0.05).At the last follow-up,the excellent-good rate of Garland-Werley wrist function scores was higher in the intramedullary nail fixation group than the Kirschner wire cross fixation group(P<0.05).There was no significant difference in the incidence rate of complications between the two groups(P>0.05).Conclusions In the treatment of children with distal 1/3 fracture of the humerus,closed reduction and elastic intramedullary nail fixation are superior to closed reduction and Kirschner wire cross fixation.

关 键 词：闭合复位 弹性髓内针 克氏针交叉固定 桡骨远段1/3处骨折 

分 类 号：R683.41[医药卫生—骨科学] R687.33[医药卫生—外科学]