超声引导再改良Métaizeau法治疗儿童严重移位不稳定的桡骨颈骨折  

Ultrasound guided further improvement of Métaizeau method for severely displaced and unstable radial neck fracture in children

作　　者：杜香平[1] 余丽蓉[1] 吴欣乐[1] 陈干[1] 熊志刚[1] 胡萍[1] DU Xiangping;YU Lirong;WU Xinle(Departmentof Orthopaedics,Jiangxi Provincial Children’s Hospital,the Affiliated Children’s Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]江西省儿童医院骨科,南昌大学附属儿童医院骨科,南昌330006

出　　处：《江西医药》2020年第10期1373-1376,共4页Jiangxi Medical Journal

基　　金：江西省重点研发计划项目,编号20202BBGL73123;江西省卫生健康委员会科技计划项目,编号20151134。

摘　　要：目的探讨超声引导再改良Métaizeau法治疗儿童严重移位不稳定的桡骨颈骨折的临床疗效。方法自2018年1月至2020年1月应用超声引导再改良Métaizeau法治疗儿童桡骨颈骨折9例:JudetⅢ型4例,JudetⅣ型5例。术中采用2枚克氏针撬拨+Métaizeau法将骨折复位,弹性髓内钉和克氏针联合固定;术后长臂前后石膏托固定4-6周,4周拔除克氏针,2-3个月拔除弹性髓内钉。结果9例患儿均成功获得闭合复位,没有中转开放复位;所有骨折均获一期愈合,平均愈合时间为5.6周;平均随访时间12.3个月。按Métaizeau标准对术后X线片评估;优良率100%;按Mayo评分标准(MEPS)评定术后肘关节功能:优良率100%。结论超声引导再改良Métaizeau法治疗儿童严重移位不稳定的桡骨颈骨折,具有辐射低、创伤小、固定稳定、并发症少等优点,可能是治疗儿童桡骨颈骨折的理想方法之一。Objective To explore the clinical effect of ultrasound-guided further improvement of Métaizeau method for severely displaced and unstable radial neck fractures in children.Methods From January 2018 to January 2020,9 cases of children's radial neck fracture were treated by Ultrasound guided further improvement of Métaizeau method.According to the Judet classification,4 cases were JudetⅢand 5 cases were JudetⅣ.During the operation,all 9 cases underwent US-guided percutaneous reduction with 2 Kirschner wires and Métaizeau method and fixation with a elastic intramedullary nail and a Kirschner wire.External fixation with plaster was used to fix the fracture for 4-6 weeks after operation,the Kirschner wire was removed 4 weeks and the elastic intramedullary nail was removed 2-3 months after surgery.Results All 9 cases were successfully closed reduction without conversion to open reduction.The mean healing time of the fracture was 5.6 weeks.All patients were followed-up 6-24 months with the average being 12.3 months.According to the Métaizeau postoperative X-ray standard,the excellent and good rate was 100%.According to the Mayo scoring system(MEPS),the excellent and good rate was 100%.Conclusion Ultrasound guided further improvement of Métaizeau method has the advantages of low radiation,small trauma,stable fixation and less complications,which may be one of the ideal methods for severely displaced and unstable radial neck fractures in children.

关 键 词：桡骨颈骨折 超声 闭合复位 儿童 

分 类 号：R726.8[医药卫生—儿科]