弹性髓内钉摇杆技术治疗儿童桡骨远端干骺交界区骨折  

Elastic intramedullary nail rocker technique for distal radius metaphyseal junction fractures in children

作　　者：周志林[1] 马海龙 孟阁 张思成[1] 袁毅[1] 孙军[1] ZHOU Zhi-lin;MA Hai-long;MENG Ge;ZHANG Si-cheng;YUAN Yi;SUN Jun(Department of Orthopedics,Anhui Childrens Hospital,Childrens MedicalCenter,Anhui Medical University,Hefei 230051,China)

机构地区：[1]安徽医科大学儿童医学中心,安徽省儿童医院骨科,安徽合肥230051

出　　处：《中国矫形外科杂志》2023年第10期917-920,共4页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:61976008)。

摘　　要：[目的]介绍弹性髓内钉摇杆技术闭合复位内固定治疗儿童桡骨远端干骺交界区骨折的手术技术和初步临床效果。[方法]对28例儿童桡骨远端干骺交界区骨折患儿行弹性髓内钉摇杆技术闭合复位内固定治疗。透视下用克氏针或止血钳定位桡骨近端“安全区”并标记,以此区为中心行切口,暴露至桡骨。开髓器钻孔,置入髓内钉,旋转弹性髓内钉手柄使骨折远端完成骨折冠状面复位,若骨折仍有旋转移位,可采用“擀面杖”技术纠正。[结果]28例患儿均顺利完成手术,未出现严重并发症。随访6~18个月,平均(8.4±4.6)个月。末次随访时,患儿腕关节活动度、握力及局部疼痛均较术前明显改善。腕关节改良Mayo评分为80~100分,平均(92.6±7.9)分。临床结果评定为优20例,良8例,优良率为100%。[结论]弹性髓内钉摇杆闭合复位内固定是治疗儿童桡骨远端干骺端骨折微创、简单、安全的方法。[Objective]To introduce the surgical technique and preliminary clinical results of closed reduction and internal fixation with elastic intramedullary nail rocker technique for the treatment of distal radius metaphyseal junction fractures in children.[Methods]A total of 28 children with distal radius metaphyseal junction fractures were treated with closed reduction and internal fixation using elastic intramedullary nail rocker technique.Under fluoroscopy,the"safe zone"of the proximal radius was located and marked with Kirschner wire or hemostatic forceps.A incision was made over the zone center to expose to the radius.An intramedullary nail selected in proper size and bended in shape was inserted into medullary cavity through an opening,and with controlling the handle of the nail to complete the coronal reduction of the fracture at the distal end.If there was still rotational displacement of the fracture,the"rolling pin"technique was used to correct it.[Results]All the 28 children were successfully operated on without serious complications,and followed up for 6 to 18 months,with an average of(8.4±4.6)months.At the latest follow-up,range of motion,grip strength,and local pain were significantly improved in all children.The modified Mayo scores ranged from 80 to 100,with an average of(92.6±7.9)at the latest follow up.The clinical results were marked as excellent in 20 cases and good in 8 cases,with the excellent and good rate of 100%.[Conclusion]The closed reduction and internal fixation with elastic intramedullary nail rocker technique is minimally invasive,simple,safe for the treatment of distal radius metaphyseal junction fractures in children.

关 键 词：儿童 桡骨骨折 内固定术 弹性髓内钉 

分 类 号：R683.41[医药卫生—骨科学]