经皮克氏针撬拨联合弹性髓内钉治疗儿童股骨长度不稳定骨折的效果观察  

Observation of effect of Kirschner wire percutaneous rotation prying combined with elastic intramedullary nails on children with length unstable femoral fractures

作　　者：薛超[1] 丁晨[1] Xue Chao;Ding Chen(Department of Orthopedics and Arthrology,Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院骨关节外科,汉中723000

出　　处：《中国实用医刊》2024年第2期11-14,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨经皮克氏针撬拨联合弹性髓内钉治疗儿童股骨长度不稳定骨折的临床效果。方法抽取2019年3月至2023年9月汉中市中心医院收治的股骨长度不稳定骨折患儿82例,按随机数字表法分为对照组与观察组,每组41例。对照组接受弹性髓内钉治疗,观察组在对照组基础上加施经皮克氏针撬拨。比较两组骨折复位优良率、围术期相关指标,比较两组治疗前后下肢功能情况[Fug-Meyer下肢评价量表(FMA-LE)评分、功能性独立评定量表(FIM)评分、功能性步行量表(FAC)评分]及应激反应相关指标[皮质醇(Cor)、去甲肾上腺素(NE)、C反应蛋白(CRP)]。结果观察组骨折复位优良率(95.12%,39/41)高于对照组(80.49%,33/41),P<0.05。观察组术中出血量、术后引流量、C臂透视次数少于对照组,且手术时间及住院时间短于对照组(P<0.05)。治疗后3个月,观察组FMA-LE、FIM、FAC评分均高于对照组(P均<0.05)。治疗后48 h,观察组Cor、NE、CRP水平均低于对照组(P均<0.05)。结论经皮克氏针撬拨联合弹性髓内钉治疗儿童股骨长度不稳定骨折,可减少术中出血量、C臂透视次数、术后引流量,缩短手术时间、住院时间,缓解应激反应,复位优良率高,术后下肢功能恢复快。Objective To investigate the effect of Kirschner wire percutaneous rotation prying combined with elastic intramedullary nails on length unstable femoral fractures in children.Methods A total of 82 children with length unstable femoral fractures admitted to Hanzhong Central Hospital from March 2019 to September 2023 were selected,and they were rdivided into a control group and an observation group by random number table method,with 41 cases in each group.The control group was treated by elastic intramedullary nails,while the observation group was treated by Kirschner wire percutaneous rotation prying based on the treatment of the control group.The excellent rate of fracture reduction and perioperative related indicators were compared between two groups.The lower limb function evaluated by Fug-Meyer assessment of lower extremity(FMA-LE)score,functional,independence measure(FIM)score and functional ambulation category(FAC)score,and stress response related indicators,including cortisol(Cor),norepinephrine(NE)and C-reative protein(CRP),were compared between the two groups before and after treatment.Results The excellent and good rate of fracture reduction in the observation group(95.12%,39/41)was higher than that in the control group(80.49%,33/41),P<0.05.The intraoperative bleeding volume,postoperative drainage volume,and C-arm fluoroscopy frequency in the observation group were lower than those in the control group,while the surgery time and hospital stay in the observation group were shorter than those in the control group(P<0.05).After 3 months of treatment,the scores of FMA-LE,FIM and FAC in the observation group were higher than those in the control group(all P<0.05).At 48 hours after surgery,the levels of Cor,NE and CRP in the observation group were lower than those in the control group(all P<0.05).Conclusions Kirschner wire percutaneous rotation prying combined with elastic intramedullary nails in the treatment of length unstable femoral fractures in children can reduce intraoperative bleeding,C-arm fluoroscopy

关 键 词：骨折 股骨长度不稳定骨折 儿童 弹性髓内钉 经皮克氏针撬拨 

分 类 号：R726.8[医药卫生—儿科]