超声在儿童前臂骨折精确引导闭合复位弹性髓内钉内固定手术中的临床应用探讨  

Clinical Discussion of Ultrasound in Closed Reduction and Elastic Intramedullary Nail Internal Fixation for Children's Forearm Fracture

作　　者：成帅 江善勇 卢建树 姜保恩 CHENG Shuai;JIANG Shanyong;LU Jianshu;JIANG Baoen(Dongying People's Hospital,Dongying 257000,Shandong China)

机构地区：[1]东营市人民医院创伤骨科,山东东营257000

出　　处：《中国中医骨伤科杂志》2023年第7期48-51,55,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨在儿童前臂尺桡骨骨折闭合复位弹性髓内钉固定手术中超声引导下操作的应用价值。方法:回顾性分析40例新鲜闭合尺桡骨骨折患儿手术资料,其中20例在超声引导下行弹性髓内钉闭合复位内固定(超声组),其他20例在常规C臂机透视引导下行弹性髓内钉闭合复位内固定(对照组)。比较分析两组的手术时间、C臂机透视次数、出血量、术后住院时间、愈合时间及手术并发症数据。结果:两组患者手术时间、术后住院时间、愈合时间和手术并发症比较,差异均无统计学意义(P>0.05)。超声组患者出血量为(15.41±3.10)mL,C臂机透视次数为(2.50±1.50)次;对照组患者出血量为(20.68±5.50)mL,C型臂透视次数为(5.80±2.50)次,两组数据差异均有统计学意义(P<0.05)。两组患儿均获得9个月的随访,最终骨折均达到骨性愈合,骨折端对位对线良好。结论:在儿童尺桡骨骨折弹性髓内钉内固定术中应用超声引导进行操作,可明显降低放射线的暴露,对骨折的复位情况可以进行动态、广角度范围的观察,进针点精确定位,减少术中盲目穿针次数,失血量少,避免术区周围神经、血管的损伤。Objective:To explore the value of ultrasound in closed reduction and elastic intramedullary nail fixation of ulnar and radial fractures in children.Methods:40 children with fresh closed ulnar and radial fractures in the Department of trauma and orthopedics of our hospital were analyzed retrospectively.Among them,20 cases were closed reduction and internal fixation with elastic intramedullary nail under the guidance of ultrasound,namely ultrasound group.The other 20 cases were treated with closed reduction and internal fixation with elastic intramedullary nail under the guidance of C-arm fluoroscopy,that is the control group.The operation time,C-arm fluoroscopy times,bleeding volume,postoperative hospital stay,healing time and surgical complications of the two groups were compared and analyzed.Results:There was no significant difference in operation time,postoperative hospital stay,healing time and surgical complications between the two groups(P>0.05).In the ultrasound group,the amount of bleeding was(15.41±3.10)mL,and the number of C-arm fluoroscopy was 2.50±1.50.The amount of bleeding in the control group was(20.68±5.50)mL and the number of fluoroscopy of C-arm was 5.80±2.50.There was significant difference between the two groups(P<0.05).The children in both groups were followed up for 9 months.Finally,the fractures reached bone healing,and the alignment of fracture ends was good.Conclusion:The application of ultrasound guidance in the internal fixation of children's ulnar and radial fractures with elastic intramedullary nails can significantly reduce the exposure of radiation,dynamically and widely observe the reduction of fractures,accurately locate the needle entry point,reduce the number of blind needle penetration during operation,reduce blood loss,and avoid the injury of peripheral nerves and blood vessels in the operation area.

关 键 词：超声引导 弹性髓内钉固定 儿童 尺桡骨骨折 闭合复位 

分 类 号：R683.41[医药卫生—骨科学]