弹性钉与外固定治疗儿童桡骨远端干骺区骨折  

Elastic stable intramedullary nailing fixation and external fixation for the treatment of distal metaphysis fracture of radius in children

作　　者：刘帅[1] 林伟枫 Liu Shuai;Lin Weifeng(Department of Pediatric Orthopedics,Wuxi 9th People's Hospital Afiliated to Suzhou University,Trauma Center of Wuxi 9th People's Hospital Affiliated to Suzhou University,Wuxi 214062,China)

机构地区：[1]苏州大学附属无锡九院小儿骨科,苏州大学附属无锡九院创伤中心,无锡214062

出　　处：《中华手外科杂志》2023年第3期210-214,共5页Chinese Journal of Hand Surgery

摘　　要：目的探讨弹性髓内钉内固定技术与外固定器技术治疗儿童桡骨远端干骺区骨折的疗效.方法回顾性分析自2017年4月至2021年3月我院收治的儿童桡骨远端干骺区骨折患者65例,采用弹性髓内钉内固定治疗27例和外固定器治疗38例.弹性钉组中5例、外固定组中12例行辅助撬拨复位,其余病例均闭合复位.以改良Green-O'Brien腕关节评分比较术后6周和末次随访时患儿肢体功能恢复情况,以独立样本t检验比较两组病例患侧腕关节屈伸侧偏和前臂旋转功能的差异,P<0.05为差异有统计学意义.结果术后随访时间为12~15个月,平均13个月.术后6周,外固定组的改良Green-O'Brien评分和腕关节、前臂活动范围均优于弹性钉组(P<0.05).末次随访时,两组病例的改良Green-O'Brien评分均为优,该评分和腕关节、前臂活动范围两组差异无统计学意义(P>0.05).结论弹性钉内固定技术和外固定器技术均可用于复位固定儿童桡骨远端干骺区骨折,并可获得满意疗效,临床应根据患儿和家属的具体诉求进行选择,以发挥方便护理和早期康复的不同优势.Objective To study the clinical efficacy of elastic stable intramedullary nailing(ESIN)and external fixator(EF)in the treatment of distal metaphysis fracture of radius in children.Methods From April 2017 to March 2021,65 children with distal metaphysis fracture of radius were treated in our hospital.27 cases were treated with ESIN and 38 cases were treated with EF.Among them,5 cases in the ESIN group and 12 cases in the EF group were performed auxiliary prying reduction,and other cases were closed reduction.The modified Green-O'Brien wrist joint score was used to compare the recovery of limb function of the children at 6 weeks after operation and at the last follow-up,and the difference between the two groups in the flexion and extension of the wrist joint and the forearm rotation function was compared by independent sample t-test.P<0.05 was statistically significant.Results The follow-up time was 12 to 15 months,with an average of 13 months.At 6 weeks after operation,the modified Green-O'Brien score and the range of motion of wrist and forearm in the EF group were better than those in the ESIN group(P<O.05).At the last follow-up,the modified Green-O'Brien score of the two groups was excellent,and there was no significant dfference between the score and the range of motion of the wrist and forearm(P>0.05).Conclusion Both ESIN internal fixation technology and EF external fixation technology can be used to reduce and fix the distal metaphysis fracture of radius in children,and can obtain satisfactory results.The clinical selection should be based on the specific demands of children and their families,so as to give play to the different advantages of convenient nursing and early rehabilitation.

关 键 词：桡骨骨折 骨折固定术 内 外固定器 弹性髓内钉 儿童 

分 类 号：R726.8[医药卫生—儿科]