克氏针撑开辅助复位弹性钉固定治疗儿童难复性桡骨下1/3骨折  

Kirschner wire retractor-assisted reduction and inverted insertion of elastic nail in the treatment of children’s irreducible subradial 1/3 fractures

作　　者：陈国富[1] 梁军波[1] 张传毅[1] 王斌[1] 蔡国平[1] 姚灿 CHEN Guo-fu;LIANG Jun-bo;ZHANG Chuan-yi;WANG Bin;CAI Guo-ping;YAO Can(Department of Orthopaedics,Taizhou Hospital,Linhai 317000,Zhejiang,China)

机构地区：[1]台州医院骨科,浙江临海317000

出　　处：《中国骨伤》2022年第8期752-756,共5页China Journal of Orthopaedics and Traumatology

基　　金：浙江省医药卫生科技计划项目(编号:2020KY356)。

摘　　要：目的:探讨克氏针撑开器辅助复位倒插弹性钉技术治疗儿童难复性桡骨下1/3骨折的临床疗效。方法:对2016年8月至2020年12月外科治疗的儿童难复性桡骨下1/3骨折34例进行回顾性分析,采用克氏针撑开器辅助闭合复位经皮弹性髓内钉行倒插钉技术治疗(观察组)16例,男10例,女6例,年龄4~10(6.0±0.4)岁;采用切开复位钢板内固定术治疗(对照组)18例,男11例,女7例,年龄3~10(7.0±0.5)岁。观察两组患者的手术时间、术中失血量、住院时间、切口长度、骨折愈合时间及并发症等指标,采用Cooney腕关节评分对患儿的腕功能进行评价。结果:所有患者获得随访,观察组随访时间3~12(11.40±0.48)个月,对照组随访时间4~13(11.50±0.39)个月。所有患者达到骨性愈合,两组患者切口均无感染。观察组的手术时间、术中出血量、住院时间、切口长度均低于对照组(P<0.05)。两组骨折愈合时间比较差异无统计学意义(P>0.05)。术后愈合情况以及恢复后的腕功能组间比较,差异均无统计学意义(P>0.05)。结论:与切开复位钢板内固定术比较,克氏针撑开辅助复位经皮弹性髓内钉固定治疗不稳定性桡骨下段1/3骨折具有创伤小、手术时间短、出血量小、近期临床疗效满意等优势。Objective:To explore the clinical effect of Kirschner wire retractor-assisted reduction and inverted insertion of elastic nail in the treatment of children’s irreducible subradial 1/3 fractures.Methods:A total of 34 children with irreducible subradial 1/3 fractures treated by surgery from August 2016 to December 2020 were retrospective analyzed.Among them,16 cases underwent Kirschner wire retractor-assisted closed reduction and percutaneous elastic intramedullary nailing with inverted insertion(observation group),10 males and 6 females,aged from 4 to 10 years old with an average of(6.0±0.4)years;18 cases underwent open reduction and plate internal fixation(control group),11 males and 7 females,the age from 3 to 10 years with an average of(7.0±0.5)years.The operation time,intraoperative blood loss,hospital stay,incision length,fracture healing time and complications of the two groups were observed and the wrist function was evaluated by Cooney wrist joint score.Results:All patients were followed up for 3-12 years old with an average of(11.40±0.48)months in the observation group and 4-13 months with an average of(11.50±0.39)months in the control group.Bone healing was achieved in all patients,and there was no incision infection in both groups.The operation time,intraoperative blood loss,hospital stay and incision length in observation groups were lower than those of control group(P<0.05).There was no significant difference in the fracture healing time between two groups(P>0.05).There was no significant difference in postoperative healing and recovery of wrist function between groups(P>0.05).Conclusion:Compared with open reduction and plate internal fixation,Kirschner wire retractor-assisted reduction and percutaneous elastic intramedullary nail fixation for irreducible subradial radial 1/3 fractures has the advantages of less trauma,shorter operation time,less blood loss,and satisfactory short-term clinical results.

关 键 词：桡骨骨折 儿童 骨折固定术 髓内 外科手术 

分 类 号：R683.41[医药卫生—骨科学]