关节镜下复位逆行交叉克氏针固定治疗儿童胫骨髁间棘骨折研究  

Arthroscopic Reduction and Retrograde Cross-Kirschner Wire Fixation for Treatment of Tibial Intercondylar Dpine Fracture in Children

作　　者：沙宝学 周威力 罗涛 SHA Baoxue;ZHOU Weili;LUO Tao(Shanghai Public Health Clinical Center, Shanghai 201500, China)

机构地区：[1]上海市公共卫生临床中心/复旦大学附属中山医院南院骨科,上海201500

出　　处：《河北医学》2020年第9期1505-1508,共4页Hebei Medicine

基　　金：上海市自然科学基金项目,(编号:13Z142702)。

摘　　要：目的:观察关节镜下复位逆行交叉克氏针固定治疗儿童胫骨髁间棘骨折研究分析。方法:将在我院(2016年10月至2019年10月)胫骨髁间棘骨折患儿80例,按简单随机数字表法分成对照组(40例)与实验组(40例),两组患儿均在关节镜下复位后实施内固定术,其中对照组患儿采取空心钉内固定,而实验组患儿采取拟行交叉克氏针固定治疗后,并对两组患儿进行10个月的有效随访。对照两组患儿手术情况(手术时长、术中出血量),手术前、10个月后疼痛VAS评分、膝关节功能Lysholm评分,随访膝关节恢复优良率、并发症及膝关节正侧位X线(再移位及骨折愈合)。结果:两组患儿手术前VAS、Lysholm评分、手术时长、术中出血量,膝关节正侧位X线下,均未出现骨折再移位、骨折未愈合情况,两组相比差异无统计学意义(P>0.05)。与治疗前相比,两组治疗10个月后VAS评分显著下降,Lysholm评分显著提升(P<0.001),其中实验组指标较对照组改善均更明显(P<0.001)。实验组患儿随访膝关节优良率为100.00%明显高于对照组患儿随访膝关节恢复优良率90.00%,实验组患儿并发症发生率为2.50%,明显少于对照组15.00%(P<0.05)。结论:儿童胫骨髁间棘骨折以关节镜下复位内固定治疗,均可明显改善术后膝关节功能,降低术后骨折再移位或未愈合情况发生,其中采取逆行交叉克氏针固定治疗,更能获得更好的术后膝关节功能,减轻术后疼痛,提高膝关节功能的恢复,减少恢复期间并发症的发生,效果理想。Objective:To observe the effect of arthroscopic reduction and retrograde cross-Kirschner wire fixation on tibial intercondylar spine fracture in children.Methods:A total of 80 children with tibial intercondylar spine fracture were treated in our hospital from October 2016 to October 2019.With the simple random number table method,they were categorized into a control group(40 cases)and an experimental group(40 cases).after arthroscopic reduction,two groups of children were treated with internal fixation.The control group was treated with hollow nail fixation,while the experimental group was treated with cross Kirschner wire fixation.After that,the two groups of children were followed up for 10 months.The operation time,bleeding volume,VAS score of pain and Lysholm score of knee joint function of the two groups before and 10 months after operation were compared.The excellent and good rate of knee joint recovery,complications and X-ray of knee joint were followed up.Results:The VAS,Lysholm score,length of operation,amount of bleeding during operation,and no fracture redisplacement or nonunion were found in both groups before operation,and there was no significant difference between the two groups(P>0.05).Compared with before treatment,the VAS scores of the two groups were significantly reduced 10 months after treatment,and the Lysholm scores were significantly improved(P<0.001).The indicators of the experimental group were more significantly improved than the control group(P<0.001).The excellent and good rate of knee joint recovery in the experimental group was 100.00%,significantly higher than that in the control group,90.00%higher than that in the follow-up.The complication rate in the experimental group was 2.50%,significantly lower than that in the control group.The incidence of symptoms was 15.00%.The difference was statistically significant(P<0.05).Conclusion:In the treatment of tibial intercondylar spine fracture in children,arthroscopic reduction and internal fixation can significantly improve knee joint fun

关 键 词：儿童胫骨髁间棘骨折 关节镜下 复位逆行 交叉克氏针固定 

分 类 号：R726.8[医药卫生—儿科]