切开复位经皮克氏针内固定治疗难复性儿童桡骨远端骨折  

Open Reduction and Percutaneous Kirschner Wire Fixation for Irreducible Distal Radius Fractures in Children

作　　者：吴青云 郭卫中 张静 WU Qingyun;GUO Weizhong;ZHANG Jing(Department of Orthopedics,Mindong Hospital Affiliated to Fujian Medical University,Ningde 355000,China;Department of Breast Surgery,Mindong Hospital Affiliated to Fujian Medical University,Ningde 355000,China)

机构地区：[1]福建医科大学附属闽东医院骨科,福建宁德355000 [2]福建医科大学附属闽东医院乳腺外科,福建宁德355000

出　　处：《中华灾害救援医学》2024年第10期1196-1199,共4页Chinese Journal of Disaster Medicine

摘　　要：目的分析对于难复性桡骨远端骨折的患儿,实施切开复位经皮克氏针内固定术的临床价值。方法对2019年5月至2023年5月福建医科大学附属闽东医院收治的60例难复性桡骨远端骨折患儿的临床资料进行回顾性分析,根据手术方案的不同,分为观察组(采用切开复位经皮克氏针内固定术)和对照组(采用切开复位钢板固定术),每组各30例。对比两组患儿围手术期相关指标、愈合时间、腕关节疼痛及活动度、临床疗效以及并发症发生情况。结果观察组患儿手术时间、术中出血量、住院时间、骨折愈合时间、拆除固定物时间均明显低于对照组患儿(P<0.001)。手术后,两组患儿Garland-Weley评分和腕关节患儿自行评估量表(Patient-Rated Wrist Evaluation,PRWE)评分均较术前明显降低(P<0.001);且观察组患儿手术后的Garland-Weley评分和PRWE评分明显低于对照组患儿(P<0.001)。观察组患儿临床疗效的优良率与对照组比较无显著差异(P>0.05),但观察组患儿并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论对于难复性桡骨远端骨折的患儿,采用切开复位经皮克氏针内固定术创伤小,有利于术后骨折愈合,促进腕关节功能的恢复,临床疗效显著,不良反应发生率低。Objective To analyze the clinical value of open reduction and percutaneous Kirschner wire fixation in pediatric patients with irreducible distal radius fractures.Methods A retrospective analysis was conducted on the clinical data of 60 pediatric patients with irreducible distal radius fractures treated at Affiliated Mindong Hospital of Fujian Medical University from May 2019 to May 2023.Based on the surgical approach,patients were divided into an observation group(open reduction with percutaneous Kirschner wire fixation,n=30)and a control group(open reduction with plate fixation,n=30).Perioperative indicators,healing time,wrist pain and range of motion,clinical efficacy,and complication rates were compared between the two groups.Results The observation group showed significantly shorter operative time,intraoperative blood loss,hospitalization time,fracture healing time,and fixation removal time compared to the control group(P<0.001).Postoperatively,both groups exhibited significant reductions in Garland-Weley and PRWE scores compared to preoperative levels(P<0.001).Additionally,the postoperative Garland-Weley and PRWE scores were significantly lower in the observation group than in the control group(P<0.001).The excellent and good clinical efficacy rates did not differ significantly between the two groups(P>0.05).However,the complication rate in the observation group was significantly lower than that in the control group(P<0.05).Conclusion For pediatric patients with irreducible distal radius fractures,open reduction with percutaneous Kirschner wire fixation offers minimal trauma,supports fracture healing,promotes wrist function recovery,and demonstrates significant clinical efficacy with a lower incidence of adverse reactions.

关 键 词：桡骨骨折 儿童 围手术期医护 桡腕关节 

分 类 号：R726.8[医药卫生—儿科]