闭合复位克氏针髓内固定和交叉固定治疗儿童桡骨远端骨折的效果对比  

Comparison of the Effect of Close Reduction Kirschner Wire Intramedullary Fixation and Crossing Fixation in the Treatment of Distal Fracture of Radius in Children

作　　者：易申德[1] 蔡军[1] 邹筠[1] YI Shende;CAI Jun;ZOU Jun(Department of Surgery,Jiangxi Provincial Children's Hospital,Nanchang 330006,China;不详)

机构地区：[1]江西省儿童医院外科,江西南昌330006

出　　处：《中国医学创新》2024年第12期5-9,共5页Medical Innovation of China

摘　　要：目的:探讨闭合复位克氏针髓内固定和交叉固定治疗儿童桡骨远端骨折的效果。方法:选取2020年5月—2023年3月江西省儿童医院外科收治的80例桡骨远端骨折患儿的临床资料进行回顾研究,按照克氏针固定方式的不同分为两组。髓内固定组(n=40)进行闭合复位克氏针髓内固定,交叉固定组(n=40)进行闭合复位克氏针交叉固定。比较两组近期疗效、手术指标、恢复指标、骨折畸形愈合和骨折再移位发生情况、腕关节功能[腕关节患者自评量表(patient-rated wrist evaluation,PRWE)、Dienst功能评分]及术后并发症发生情况。结果:术后4周,两组患儿尺偏角、掌倾角、桡骨缩短长度均得到明显改善,髓内固定组尺偏角、掌倾角均大于交叉固定组,桡骨缩短长度短于交叉固定组(P<0.05)。两组手术时间、术中出血量、术中透视次数、住院时间、治疗费用、骨折畸形愈合率、优良率、并发症发生率比较,差异均无统计学意义(P>0.05)。髓内固定组骨折愈合时间短于交叉固定组,骨折再移位发生率低于交叉固定组(P<0.05)。髓内固定组术后2、4、8周PRWE评分均低于交叉固定组(P<0.05)。结论:在儿童桡骨远端骨折中,闭合复位克氏针髓内固定治疗的近期效果优于交叉固定,可增加稳定性并加快骨折愈合,但两种置针方式的安全性并无统计学差异。Objective:To explore the effect of close reduction Kirschner wire intramedullary fixation and crossing fixation in the treatment of distal fracture of radius in children.Method:Clinical data of 80 children with distal fracture of radius admitted to Department of Surgery,Jiangxi Provincial Children's Hospital from May 2020 to March 2023 were selected for retrospective study,and they were divided into two groups according to the different fixation methods of Kirschner wire.The intramedullary fixation group(n=40)underwent close reduction Kirschner wire intramedullary fixation,and the crossing fixation group(n=40)underwent close reduction Kirschner wire crossing fixation.The short-term effect,surgical indexes,recovery indexes,incidence of malunion of fracture and fracture redisplacement,carpal joint function[patient-rated wrist evaluation(PRWE),Dienst function score]and postoperative complications were compared between the two groups.Result:At 4 weeks after surgery,ulnar inclination,palmar tilt and radial shortening length in both groups were improved significantly,ulnar inclination and palmar tilt in intramedullary fixation group were greater than those in crossing fixation group,and the radial shortening length was shorter than that in crossing fixation group(P<0.05).There were no significant differences in operation time,intraoperative bleeding volume,intraoperative fluoroscopy times,hospital stay,treatment cost,malunion of fracture rate,excellent and good rate and complication rate between the two groups(P>0.05).The fracture healing time of intramedullary fixation group was shorter than that of crossing fixation group,and the incidence of fracture redisplacement was lower than that in crossing fixation group(P<0.05).The PRWE scores of intramedullary fixation group at 2,4 and 8 weeks after surgery were lower than those of crossing fixation group(P<0.05).Conclusion:In children with distal fracture of radius,the short-term effect of close reduction Kirschner wire intramedullary fixation is better than that of crossi

关 键 词：闭合复位 克氏针 髓内固定 交叉固定 桡骨远端骨折 

分 类 号：R726.8[医药卫生—儿科]