闭合复位内外侧经皮克氏针交叉置针与桡侧扇形克氏针治疗儿童肱骨髁上骨折的疗效比较  

Efficacy of closed reduction and fixation with medial⁃lateral percutaneous Kirschner wire versus fan⁃shaped radial Kirschner wire on pediatric supracondylar fracture of humerus

作　　者：黄乙勇 符凯 洪聪 朱立宁 Huang Yiyong;Fu Kai;Hong Cong;Zhu Lining(Department of Pediatric Orthopedics,Hainan Women and Children’sMedical Center,Haikou 570100,China)

机构地区：[1]海南省妇女儿童医学中心小儿骨科,海南海口570100

出　　处：《海军医学杂志》2024年第6期638-642,共5页Journal of Navy Medicine

基　　金：海南自然科学基金面上项目(20168326)。

摘　　要：目的 比较闭合复位内外侧经皮克氏针交叉置针与桡侧扇形克氏针治疗儿童肱骨髁上骨折的疗效。方法 前瞻性选取2019年9月至2021年9月海南省妇女儿童医学中心收治的肱骨髁上骨折患儿120例为研究对象,随机分为研究组与对照组各60例。对照组采取闭合复位内外侧经皮克氏针交叉置针治疗,研究组采用闭合复位桡侧扇形克氏针治疗。比较2组手术时间,术后恢复指标,术前、手术当天与术后12周的视觉模拟量表(VAS)评分以及术后12周疗效与并发症发生情况。结果 2组在手术时间、住院时间、骨折愈合时间方面比较差异无统计学意义(P>0.05)。2组术后当天的VAS评分与术前相比均升高,术后12周的VAS评分与术前和术后当天比较均降低(P<0.05),术前、术后当天、术后12周2组VAS评分比较差异无统计学意义(P>0.05)。研究组肘关节功能优良率高于对照组(P<0.05)。研究组医源性尺神经损伤发生率和并发症总发生率低于对照组(P<0.05)。结论 闭合复位内外侧经皮克氏针交叉置针与桡侧扇形克氏针治疗儿童肱骨髁上骨折均有良好的愈合效果,但闭合复位桡侧扇形克氏针疗效更好,可有效促进肘关节功能的恢复,减少并发症的发生。Objective To compare the clinical efficacies of closed reduction and fixation with medial-lateral percutaneous Kirschner wire and fan-shaped radial Kirschner wire in children with supracondylar humerus fractures.Methods A total of 120 pediatric supracondylar humerus fracture patients who were admitted to Department of Pediatric Orthopedics,Hainan Women and Children’s Medical Center from September 2019 to September 2021 were enrolled in this prospective study.They were randomly divided into study group and control group,with 60 cases in each group.The control group received closed reduction and fixation with medial-lateral percutaneous Kirschner wire.The study group underwent closed reduction and fixation with fan-shaped radial Kirschner wire.The operation time,indexes related to postoperative recovery,visual analog scale(VAS)scores before surgery,during surgery and at 12 weeks after surgery,postoperative efficacy and complications 12 weeks after surgery were compared between the two groups.Results There were no significant differences between the two groups in the operation time,hospitalization time or fracture healing time(all P>0.05).The VAS scores on the day after surgery were higher than those before surgery in both groups,and the VAS scores at 12 weeks after surgery were lower than those before surgery and on the day after surgery in both groups(all P<0.05).But there was no significant difference between the two groups in the VAS scores before surgery,on the day after surgery,or 12 weeks after surgery(P>0.05).The excellent and good rates of elbow function and appearance recovery in the study group were significantly higher than those in the control group(all P<0.05).The incidence of iatrogenic ulnar nerve injury and total incidence of complications in the study group were significantly lower than those in the control group(all P<0.05).Conclusion Closed reduction and fixation with medial-lateral percutaneous Kirschner wire and fan-shaped radial Kirschner wire are both effective for pediatric supracondylar f

关 键 词：肱骨髁上骨折 儿童 闭合复位内外侧经皮克氏针交叉置针 闭合复位桡侧扇形克氏针 疗效 

分 类 号：R68[医药卫生—骨科学]