经皮克氏针固定与弹性髓内钉内固定治疗儿童桡骨颈骨折的疗效比较  

Comparison of percutaneous Kirschner wiring and elastic intramedullary nailing for radial neck fractures in children

作　　者：马海龙 孙锡玮 刘方[1] 华中托 袁毅[1] 张思成[1] Ma Hailong;Sun Xiwei;Liu Fang;Hua Zhongtuo;Yuan Yi;Zhang Sicheng(Department of Orthopedics,Children's Hospital of Anhui Province,Children's Medical Center of Anhui Medical University,Hefei 230051,China)

机构地区：[1]安徽省儿童医院,安徽医科大学儿童医学中心骨科,合肥230051

出　　处：《中华创伤骨科杂志》2024年第8期691-697,共7页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金(U19A2057);安徽省卫生健康科研项目(AHWJ2022b008);安徽医科大学校基金青年科学基金(2023xkj217);安徽省儿童医院科研项目(21etyy012)。

摘　　要：目的比较通过超声引导撬拨复位后采用经皮克氏针固定与弹性髓内钉内固定治疗儿童桡骨颈骨折的疗效。方法回顾性分析2020年1月至2023年1月安徽省儿童医院收治的96例桡骨颈骨折患儿资料。男51例,女45例;年龄(7.0±2.5)岁;骨折Judet分型:Ⅲ型74例,Ⅳ型22例。21例采用超声引导撬拨复位经皮克氏针固定治疗(克氏针组),75例采用超声引导撬拨复位弹性髓内钉内固定治疗(髓内钉组)。比较两组患者手术时间、透视次数、骨折愈合时间、术后Métaizeau标准的骨折复位情况、末次随访时Steel和Gtrham评分的肘关节功能及并发症发生情况。结果两组患儿术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。96例患儿术后获(10.6±4.2)个月随访。克氏针组患儿的手术时间[(18.5±2.6)min]、透视次数[4.0(3.0,4.0)次]均显著少于髓内钉组[(30.9±2.7)min、8.0(7.0,9.0)次],差异均有统计学意义(P<0.05)。克氏针组与髓内钉组骨折愈合时间、术后Métaizeau标准的骨折复位优良率、末次随访时Steel和Gtrham评分的肘关节功能优良率、并发症发生率比较差异均无统计学意义(P>0.05)。结论超声引导撬拨复位后经皮克氏针固定与撬拨复位弹性髓内钉内固定治疗儿童桡骨颈骨折效果相当,但前者可减少手术时间和术中透视次数,且无需二次手术。ObjectiveTo compare percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction in the treatment of radial neck fractures in children.MethodsA retrospective study was conducted to analyze the 96 children with radial neck fracture who had been admitted to Department of Orthopedics,Children's Hospital of Anhui Province from January 2020 to January 2023.They were 51 boys and 45 girls with an age of(7.0±2.5)years.By the Judet classification,there were 74 cases of typeⅢand 22 cases of type IV.Twenty-one cases were treated with percutaneous Kirschner wiring after ultrasound-guided reduction(Kirschner wire group)while 75 cases with elastic intramedullary nailing after ultrasound-guided reduction(intramedullary nail group).The surgical time,fluoroscopy frequency,fracture healing time,and incidence of complications were compared between the 2 groups.Their postoperative X-ray films were evaluated according to the Métaizeau criteria,and elbow joint function was evaluated according to the Steel and Gtrham scoring at the last follow-up.ResultsThere was no statistically significant difference in the preoperative general data between the 2 groups,indicating comparability(P>0.05).The 96 pediatric patients were followed up for(10.6±4.2)months after surgery.The surgical time[(18.5±2.6)minutes]and fluoroscopy frequency[4.0(3.0,4.0)times]in the Kirschner wire group were significantly less than those in the intramedullary nail group[(30.9±2.7)minutes,8.0(7.0,9.0)times](P<0.05).There was no statistically significant difference in fracture healing time,good and excellent rate of postoperative reduction by the Métaizeau criteria,good and excellent rate of elbow joint function by the Steel and Gtrham scoring at the last follow-up,or incidence of complications(P>0.05).ConclusionIn the treatment of radial neck fractures in children,both ultrasound-guided percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction can lead to similar therapeutic effects,bu

关 键 词：儿童 超声检查 骨折固定术 内 桡骨颈骨折 克氏针 弹性髓内钉 

分 类 号：R726.8[医药卫生—儿科]