克氏针与埋头钉固定青少年肱骨小头骨折的比较  

Kirschner wire versus headless screw for internal fixation of humeral capitellar fracture in adolescents

作　　者：姚杰[1] 贾国强 孙军[1] 袁毅[1] 金斌 YAO Jie;JIA Guo-qiang;SUN Jun;YUAN Yi;JIN Bin(Department of Orthopedics,Children's Hopia,Anhui Medical Uniteriy,Hefei 230051,China)

机构地区：[1]安徽医科大学附属省儿童医院骨科,安徽合肥230051

出　　处：《中国矫形外科杂志》2022年第14期1318-1321,共4页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目(编号:61976008)。

摘　　要：[目的]比较切开复位克氏针和埋头钉内固定治疗青少年肱骨小头骨折手术疗效。[方法]2017年9月—2021年4月,开放复位内固定肱骨小头骨折22例患儿,根据医患沟通结果,12例采用克氏针固定,10例采用埋头钉固定。比较两组临床与影像结果。[结果]所有患儿均顺利完成手术,两组手术时间、切口长度、术中出血量、透视次数、住院天数的差异均无统计学意义(P>0.05),但埋头钉组住院费用显著高于克氏针组(P<0.05)。患儿平均随访时间(31.04±4.05)个月。末次随访时所有患儿肘关节外观良,无明显的肘内外翻畸形,无肘关节屈曲明显受限。相应时间点两组间上述评分的差异均无统计学意义(P>0.05)。影像方面,两组骨折质量和影像骨折愈合时间,以及末次随访时提携角和肱骨-小头角的差异均无统计学意义(P>0.05)。[结论]对于青少年肱骨小头骨折切开复位克氏针或埋头钉内固定均可获得满意临床效果。[Objective]To compare the clinical outcomes of open reduction and internal fixation(ORIF)with Kirschner wire versus headless screw for humeral capitellar fractures in adolescents.[Methods]From September 2017 to April 2021,a total of 22 adolescents underwent ORIF for capitellar fractures.According to preoperative doctor-patient communication,12 patients had fracture fixed with Kirschner wire(KW),while the other 10 patients were treated with headless screw(HS).The clinical and imaging documents were compared between the two groups.[Results]All the patients were successfully operated on with no significant differences in operative time,incision length,intraoperative blood loss,number of fluoroscopy and hospital stay between the two groups(P<0.05),but the HS group got significantly higher hospitalization cost than the KW group(P<0.05).At the latest follow up lasted for(31.04±4.05)months on average,all the adolescents in both groups got good appearance of elbow,without obvious varus deformity,and limitation of elbow flexion,and there were no significantly differences in terms of Mayo and Quick-Dash score between the two groups(P<0.05).Radiographically,there were no significant differences in fracture reduction quality,radiographic fracture healing time,as well as the carrying angle and humeral-capitellar angle measured on radiographs at the latest follow up between the two groups(P>0.05).[Conclusion]Both Kirschner wire and headless screw used for internal fixation do achieve satisfactory clinical outcomes for humeral capitellar fractures in the adolescents.

关 键 词：肱骨小头骨折 青少年 开放复位内固定 克氏针 埋头钉 

分 类 号：R683.41[医药卫生—骨科学]