闭合复位经皮克氏针内固定治疗儿童桡骨远端骨骺骨折的临床效果研究  

Study on clinical effect of closed reduction and percutaneous Kirschner wire internal fixation for epiphyseal fractures of the distal radius

作　　者：马洪[1] 柯华荣 郭跃明[1] 卢凤珊[1] MA Hong;KE Hua-rong;GUO Yue-ming(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院,528000

出　　处：《中国现代药物应用》2023年第21期16-21,共6页Chinese Journal of Modern Drug Application

基　　金：2020年度佛山市卫生健康局医学科研课题(项目编号:20200446)。

摘　　要：目的 探索闭合复位经皮克氏针内固定治疗儿童桡骨远端骨骺骨折的临床效果。方法 80例桡骨远端骨骺骨折患儿,随机分为观察组和对照组,每组40例。观察组患儿采用闭合复位经皮克氏针内固定治疗,对照组患儿采用闭合复位夹板外固定治疗。比较两组视觉模拟评分法(VAS)评分、骨性愈合时间、去除固定物时间、腕关节功能活动度、临床疗效、并发症发生情况。结果 经Bonferroni检验提示,治疗前两组VAS评分比较差异无统计学意义(P>0.05),组间效应分析提示两组总体VAS评分比较差异具有统计学意义(P<0.05)。治疗第3、7天,观察组VAS评分(5.430±1.740)、(3.900±1.680)分低于对照组的(6.230±1.640)、(5.200±1.860)分,差异具有统计学意义(P<0.05)。所有患儿骨折在8~14周内愈合,平均骨性愈合时间为12.385周,两组骨性愈合时间比较差异无统计学意义(P>0.05)。所有患儿骨折在4~6周去除固定物,平均去除固定物时间为5.005周,两组去除固定物时间比较差异无统计学意义(P>0.05)。两组掌倾角、尺偏角以及腕关节掌屈、背伸、桡偏、尺偏、旋前、旋后角度比较差异无统计学意义(P>0.05)。两组临床疗效比较差异无统计学意义(P>0.05);两组优良率比较差异无统计学意义(P>0.05)。观察组并发症发生率12.5%低于对照组的35.0%,差异具有统计学意义(P<0.05)。结论 对于儿童桡骨远端骨骺骨折,闭合复位克氏针内固定石膏外固定与闭合复位夹板外固定治疗均可获得满意的疗效,但克氏针内固定具有固定稳固、早期疼痛改善、并发症相对少等优点,值得进一步推广。Objective To investigate the clinical effect of closed reduction and percutaneous Kirschner wire internal fixation for epiphyseal fractures of the distal radius.Methods A total of 80 children with epiphyseal fractures of the distal radius were randomly divided into an observation group and a control group,with 40 cases in each group.The observation group was treated with closed reduction and percutaneous Kirschner wire internal fixation,and the control group was treated with closed reduction and splint external fixation.The visual analogue scale(VAS)score,bone healing time,fixation removal time,wrist range of motion,clinical efficacy and complications were compared between the two groups.Results Bonferroni test suggested that there was no statistically significant difference in VAS score between the two groups before treatment(P>0.05),and intergroup effect analysis suggested that there was statistically significant difference in VAS score between the two groups(P<0.05).On the 3rd and 7th day of treatment,VAS scores were(5.430±1.740)and(3.900±1.680)points in the observation group,which were lower than those of(6.230±1.640)and(5.200±1.860)points in the control group,and the differences were statistically significant(P<0.05).All patients underwent fixation removal at 4-6 weeks,with an average removal time of 5.005 weeks.There was no statistically significant difference in the fixation removal time between the two groups(P>0.05).There was no statistically significant difference in palmar inclination angle,ulnar inclination angle,palmar flexion angle,dorsiflexion angle,radial deviation angle,ulnar deviation angle,pronation angle,supination angle between the two groups(P>0.05).There was no statistically significant difference in clinical efficacy between the two groups(P>0.05).There was no statistically significant difference in the excellent rate between the two groups(P>0.05).The complication rate of 12.5%in the observation group was lower than that of 35.0%in the control group,and the difference was statisticall

关 键 词：儿童 桡骨远端骨骺骨折 闭合复位 克氏针 效果 

分 类 号：R246.4[医药卫生—针灸推拿学]