外侧入路关节造影辅助治疗儿童孟氏骨折  

Application of elbow arthrography through lateral approach in assisted treatment of Monteggia fracture in children

作　　者：希伦 王鹏 秦志明 高志明 李志刚 XI Lun;WANG Peng;QIN Zhiming;GAO Zhiming;LI Zhigang(Department of Orthopedics,The Affiliated Hospital of Chifeng University,Chifeng 024000,Inner Mongolia Autonomous Region,China)

机构地区：[1]赤峰学院附属医院骨科,内蒙古赤峰024000

出　　处：《西部医学》2022年第8期1174-1177,共4页Medical Journal of West China

摘　　要：目的探讨外侧入路关节造影辅助治疗在儿童孟氏骨折的应用效果。方法回顾性分析赤峰学院附属医院于2009年6月~2020年6月诊治的54例儿童孟氏骨折患者的临床资料,根据是否行肘关节造影分为造影组(24例)和非造影组(30例)。分析对比两组患者的手术时间、透视次数、住院费用、术后VAS评分、骨折愈合时间、临床疗效以及并发症发生情况。结果造影组患者的手术时间和透视次数均明显少于非造影组(P<0.05);两组患者的住院费用、术后VAS评分、骨折愈合时间、肘关节屈伸活动度和前臂旋转活动度以及临床疗效优良率比较差异均无统计学意义(P>0.05)。两组患者分别各有1例出现克氏针钉尾激惹症状,拔出后消失;非造影组发生骨骺早闭2例,桡骨头再脱位1例,造影组无骨骺早闭和桡骨头再脱位发生,也无造影剂过敏等不良反应发生。两组患者均无切口感染、神经损伤、骨折畸形愈合、桡骨头坏死、关节僵硬、骨化性肌炎等并发症发生;造影组患者的并发症发生率明显低于非造影组(P<0.05)。结论除了能节省手术时间、减少辐射外,采用外侧入路肘关节造影辅助治疗儿童孟氏骨折还能减轻患者术后疼痛及经济负担,不影响临床治疗效果。Objective To explore the clinical effect of elbow arthrography through lateral approach in assisted treatment of Monteggia fracture in children.Methods A retrospective analysis was performed on the clinical data of 54 children with Mengzi fracture treated in The Affiliated Hospital of Chifeng University from June 2009 to June 2020.According to whether elbow arthrography was performed,the patients were divided into contrast group(n=24)and non-contrast group(n=30).The operation time,fluoroscopic times,hospitalization cost,Postoperative VAS score,fracture healing time,clinical efficacy and complications of the two groups were analyzed and compared.Results The operation time and the times of fluoroscopy in the contrast group were significantly less than those in the non-contrast group(P<0.05).There were no significant differences between the two groups in hospitalization cost,postoperative VAS score,fracture healing time,elbow flexion and extension range of motion and forearm rotation range of motion and clinical efficacy(P>0.05).One patient in each of the two groups had symptoms of Kirschner wire tail irritation,which disappeared after being pulled out.There were 2 cases of premature closure of the epiphysis and 1 case of re-dislocation of the radial head in the non-contrast group,while no premature closure of the epiphysis and re-dislocation of the radial head occurred in the contrast group.There were no incision infection,nerve injury,fracture malunion,necrosis of radius head,joint stiffness,myositis ossificans,and no adverse reactions such as contrast agent allergy.The incidence of complications in the contrast group was significantly lower than that in the non-contrast group(P<0.05).Conclusion The application of elbow arthrography through lateral approach in assisted treatment of Monteggia fracture in children,in addition to saving operation time,reducing radiation,it can also reduce complications without increasing postoperative pain and economic burden of patients,and without affecting fracture healing and cli

关 键 词：孟氏骨折 关节造影 外侧入路 治疗 

分 类 号：R683[医药卫生—骨科学]