闭合复位双枚克氏针髓腔内固定治疗儿童桡骨下1/3骨折  

Closed reduction and intramedullary fixation with double pins for pediatric 1/3 distal radial fracture

作　　者：龚冰南 吕辉照 王江波 林顺新 赵枫[1] Gong Bingnan;Lv Huizhao;Wang Jiangbo;Lin Shunxin;Zhao Feng(The 2nd Department of Orthopedics,910th Hospital of Chinese PLAf Quanzhou Fujian,362000,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院骨二科,福建泉州362000

出　　处：《生物骨科材料与临床研究》2021年第1期47-50,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的 探讨闭合复位双枚克氏针髓腔内固定治疗儿童桡骨下1/3骨折的临床疗效。方法 自2016年3月至2018年9月中国人民解放军联勤保障部队第910医院共收治儿童桡骨下1/3骨折69例。其中,男52例,女17例;年龄6~13岁,平均(9.2±2.1)岁。受伤至手术时间2~50 h,平均(25.3±11.9) h。骨折AO分型:A2型12例,A3型46例,B2型10例,B3型1例。所有患者分为克氏针组和钢板组,其中克氏针组30例,采用闭合复位双枚克氏针髓腔内固定;钢板组39例,采用切开复位微型钢板内固定。记录手术时间、术中出血量、住院时间、骨折愈合时间和前臂Grace-Enversman功能分级。结果 69例患者均获得随访,随访时间14~44个月,平均(22.8±3.2)个月。克氏针组的手术时间、出血量和住院时间少于钢板组,差异有统计学意义(<0.05)。克氏针组骨折临床愈合时间为4~6周,平均(4.2±0.2)周;钢板组骨折临床愈合时间为8~12周,平均(11.0±0.8)周;两组间比较差异有统计学意义(=12.021,<0.05)。克氏针组与钢板组间的前臂Grace-Enversman功能比较,差异无统计学意义(>0.05)。克氏针组与钢板组间的腕关节活动度比较,差异无统计学意义(>0.05)。结论 双枚克氏针髓腔内固定治疗儿童桡骨下1/3骨折,具有微创、操作简单和疗效满意的优点,是可选的治疗方式之一。Objective To evaluate the effect of closed reduction and intramedullary fixation with double pins for pediatric1/3 distal radial fracture.Methods Between March 2016 and September 2018,there were 69 patients underwent 1/3 distal radial fractures.There were 52 males and 17 females.The average age was(9.2±2.1)years,ranged from 6 to13 years;the average interval time between trauma and operation was(25.3±11.9)h,ranged from 2 to 50 h.According to AO classification,there were 12 cases in grade A2,46 cases in grade A3,10 cases in grade B2 and 1 case in grade B3.All patients were divided into pin group and plate group.30 patients in pin group were treated by closed reduction and intramedullary fixation with double pins,and 39 patients in plate group were treated by open reduction and plate fixation.The operation time,blood loss,inpatient time,fracture healing time and forearm Grace-Enversman score were recorded.Results All 69 patients were followed up for(90.2±9.8)weeks(range 72 to 120 weeks).There was significant difference between two groups about operation time,blood loss,inpatient time(P<0.01).The fracture healing time was(4.2±0.2)weeks(range 4 to 6 weeks)in pin group,and(11.0±0.8)weeks(range 8 to 12 weeks)in plate group,and there was significant difference between the two groups(P<0.05).There was no significant difference between two groups about forearm Grace-Enversman score(P>0.05).There was no significant difference between two groups about wrist movement angle(P>0.05).Conclusion Intramedullary fixation with double pins for pediatric 1/3 distal radial fracture,has advantages of micro-infixation,simplify operation and efficiency,and it is a optional treatment method.

关 键 词：桡骨下1/3骨折 儿童骨折 克氏针固定 髓腔内固定 

分 类 号：R683.41[医药卫生—骨科学]