经尺侧杠杆操纵技术辅助复位治疗儿童桡骨颈骨折25例  

Reduction Assisted by Ulnar Lever Manipulation Technique for the Treatment of Radial Neck Fracture in Children 25 Cases

作　　者：练志平 揭强 王建嗣 宫伟 LIAN Zhiping;JIE Qiang;WANG Jiansi;GONG Wei(Quanzhou Orthopedic-Traumatological Hospital,Quanzhou 362000,Fujian China)

机构地区：[1]泉州市正骨医院,福建泉州362000

出　　处：《中国中医骨伤科杂志》2024年第9期86-88,93,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨经尺侧杠杆操纵技术辅助复位微创治疗儿童桡骨颈骨折的应用价值和安全性。方法:自2021年6月至2023年4月,选择儿童桡骨颈骨折患儿25例,男14例,女11例;年龄为5~12岁,平均年龄为7.6岁;采用经尺侧杠杆操纵技术辅助复位微创治疗儿童桡骨颈骨折。术后均配合上肢长臂中立位石膏托固定4~6周,之后拆除石膏开始主动功能训练。结果:所有患儿均密切随访,平均随访时间为15.3个月(8~24个月),25例骨折均一期愈合,无伤口感染,无神经血管损伤。末次随访时,肘关节及前臂功能参照Métaizeau后期疗效标准评定,优良率为92%。结论:微创治疗儿童桡骨颈骨折采用经尺侧杠杆操纵技术辅助复位,相较于常规桡侧克氏针撬拨复位及切开复位,具有操作简单、医源性损伤小、愈合快等优势,可作为桡骨颈骨折众多复位方法的选择方案之一,值得临床推广应用。Objective:To investigate the application value and safety of transulnar lever manipulation in minimally invasive treatment of radial neck fractures in children.Methods:From June 2021 to April 2023,25 children with radial neck fracture(14 males and 11 females)were selected.Age ranged from 5 to 12 years old,with an average age of 7.6 years old.Minimally invasive treatment of radial neck fractures in children with assistant reduction by transulnar lever manipulation.After the operation,they were fixed in a neutral cast for 46 weeks,and then the cast was removed and active functional training began.Results:All the children were followed up closely,with an average follow-up time of 15.3 months(824 months).All the 25 cases had primary healing,no wound infection,and no neurovascular injury.At the last follow-up,elbow joint and forearm function were evaluated with reference to Métaizeau's late efficacy criteria,and the excellent rate was 92%.Conclusion:The ulnar lever manipulation technique used in minimally invasive treatment of children with radial neck fractures has the advantages of simple operation,less iatrogenic injury and faster healing compared with conventional radial Kirschler needle prying reduction and open reduction.It can be used as one of the effective options for the reduction of radial neck fractures and is worthy of clinical promotion and application.

关 键 词：桡骨颈骨折 杠杆操纵技术 辅助复位 儿童 

分 类 号：R683.41[医药卫生—骨科学]