闭合复位经皮弹性髓内钉治疗儿童锁骨骨折的临床疗效评估  

Clinical evaluation of closed reduction and percutaneous elastic intramedullary nail for clavicle fracture in children

作　　者：许益文[1] 郑勇[1] 周慧敏 石振[1] 游景扬[1] 陶春杰 王震 Xu Yiwen;Zheng Yong;Zhou Huimin;Shi Zhen;You Jingyang;Tao Chunjie;Wang Zhen(Department of Orthopedics,Tong Ji Xianning Hospital Affiliated to Huazhong University of Science and Technology,Xianning Hubei,437000,China)

机构地区：[1]华中科技大学同济咸宁医院(咸宁市中心医院),湖北咸宁437000

出　　处：《生物骨科材料与临床研究》2022年第5期61-65,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的 探讨闭合复位经皮钛制弹性髓内钉固定治疗儿童锁骨骨折的临床疗效。方法 回顾性分析华中科技大学同济咸宁医院自2019年9月至2021年1月收治的58例儿童锁骨骨折的临床资料,分别采用闭合复位经皮弹性髓内钉固定治疗(29例,TEN治疗组)和“8”字绷带(或锁骨固定带)外固定保守治疗(29例,保守治疗组)。测量两组患儿锁骨的长度,锁骨功能按Costant评分与Wolfgang评分系统来评估。结果 两组58例患儿均得到随访12~24个月。TEN治疗组和保守治疗组术前VAS疼痛评分比较,差异无统计学意义(P>0.05);两组术后1 d VAS疼痛评分比较,差异有统计学意义(P<0.05),TEN治疗组术后能够及时缓解骨折处疼痛。末次随访时TEN治疗组锁骨短缩距离少于保守治疗组,差异有统计学意义(P<0.05)。锁骨功能按Costant评分与Wolfgang评分:两组末次随访时Costant评分比较,差异无统计学意义(P>0.05),两组患儿末次随访时在疼痛、活动度、肌力、日常生活活动功能方面相同;但两组Wolfgang评分比较,差异有统计学意义(P<0.05),证明TEN治疗组较保守治疗组术后满意度更高。结论 闭合复位经皮钛制弹性髓内钉治疗儿童锁骨骨折能有效缓解骨折处疼痛、创伤小、恢复快,患儿家长容易接受且满意度高,具有骨折固定牢固、术中术后并发症少等优点,值得临床应用。Objective To study the treatment of closed reduction and percutaneous titanium elastic nail fixation on clavicle fracture in children. Methods A retrospective analysis was performed on the clinical data of 58 children with clavicular fracture in Tong Ji Xianning Hospital Affiliated to Huazhong University of Science and Technology from September 2019to January 2021. The experimental group of 29 children were treated by closed reduction and percutaneous titanium elastic nail fixation(TEN treatment group). The control group of 29 children were treated conservatively with "8" bandage of external fixation band(conservative treatment group). The length of the clavicle was measured in both groups after treatment, and the function of the clavicle was assessed by Costant score and Wolfgang score system. Results Fifty-eight cases in both groups were followed up for 12-24 months. There was no significant difference in preoperative VAS pain score between the TEN treatment group and the conservative treatment group(P>0.05). The postoperative VAS scores at the first day of the two groups were statistically different(P<0.05), so it showed that the elastic nail treatment group could relieve the pain at the fracture site in time. At the last follow-up, the affected clavicle shortening distance of the TEN treatment group was less than that of the conservation treatment group, and the difference between the two groups was statistically significant(P<0.05). The scores of clavicle function were evaluated according to Costant and Wolfgang score systems. Costant score was not significantly different between the two groups at the last follow-up(P>0.05). It was the same between the two groups at the respects of pain, range of motion, muscle strength and daily living activities at the last follow-up. However, Wolfgang score was statistically different between the two groups(P<0.05). It proved that the elastic nail group had higher postoperative satisfaction than the conservative treatment group. Conclusion The method of closed reduction a

关 键 词：闭合复位 经皮 钛制弹性髓内钉 儿童 锁骨骨折 

分 类 号：R683[医药卫生—骨科学]