克氏针固定治疗儿童骨折的并发症分析  

Complications of Kirschner wire fixation in treatment of pediatric fractures

作　　者：马睿[1] 陈辉[1] 林峰[1] MA Rui;CHEN Hui;LIN Feng(Department of Opthopaedics,Hainan Branch of Chinese PLA General Hospital,Sanya 572000,Hainan Province,China)

机构地区：[1]解放军总医院海南医院骨科,海南三亚572000

出　　处：《解放军医学院学报》2020年第11期1081-1084,1104,共5页Academic Journal of Chinese PLA Medical School

摘　　要：目的分析克氏针固定儿童骨折的相关并发症,探讨出现并发症后的解决方法。方法分析我院2015年1月-2019年12月采用克氏针手术治疗的儿童骨折病例43例,克氏针固定超过4周组共27例,其中男童15例,女童12例,年龄0.5~12岁,术后随访时间(16.17±5.15)周;克氏针固定不超过4周组共16例,其中男童10例,女童6例,年龄1~13岁,术后随访时间(16.29±5.09)周。通过术后两组患肢外观、病例记录及X线片进行并发症评估。结果43例中有14例出现并发症,并发症发生率33%。其中针道感染14例,拔除时克氏针松动9例,克氏针移动4例,肉芽过度生长2例,骨质过度生长1例,神经感觉运动障碍2例。所有骨折均愈合,克氏针留置时间超过4周组较不超过4周组并发症发生率高(44.4%vs 12.5%,P=0.03)。结论克氏针治疗的并发症均为轻度和短期。详细的术前规划、术中正确置针、高水平的术后护理,可以有效避免并发症发生。Objective To analyze the related complications of Kirschner wire fixation in treatment of pediatric fractures and explore effective measures.Methods A retrospective analysis was carried out in 43 children with fractures undergoing orthopaedic surgery by K-wires fixation in our department from January 2015 to December 2019.Of the 27 cases who had Kirschner wire fixation for more than 4 weeks,there were 15 boys and 12 girls with age ranging from 0.5-12 years old,and they were followed up for(16.17±5.15)months.In the K-wire indwelled for less than 4 weeks group,there were 10 boys and 6 girls with age ranging from 1-13 years old and follow-up duration of(16.29±5.09)months.Their postoperative appearance of the affected limb,case record and X-ray were evaluated and compared between the two groups.Results A total of 14 patients developed complications with the incidence of 33%.Pin tract infection was found in 12 cases,K-wire loosening in 9 cases,wire migration in 4 case,over-granulation in 2 cases,bone overgrowth in 1 case,and neurapraxia in 2 cases.All the cases got fracture healing,and the incidence of complications was higher in the K-wire fixation>4 weeks group than the K-wire fixation≤4 weeks group(44.4%vs 12.5%,P=0.03).Conclusion The complications in K-wire fixation for fracture in children are mild and short-term.Detailed preoperative planning,correct needle placement during operation and improvement of postoperative nursing level can effectively avoid complications.

关 键 词：克氏针 并发症 儿童骨折 针道感染 克氏针移位 

分 类 号：R726.8[医药卫生—儿科]