两种不同克氏针固定方式治疗儿童Campbell Ⅱ型近节指骨骺旁骨折的疗效比较  

Comparison of two modalities of Kirschner pin fixation for severely displaced(Campbell typeⅡ)juxta-epiphyseal fracture of the proximal phalanx in children

作　　者：王帅印[1] 黄子龙 李佳卉 付桂兵[1] Wang Shuaiyin;Huang Zilong;Li Jiahui;Fu Guibing(Department of Orthopaedics,Shenzhen Children's Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市儿童医院骨科,深圳518000

出　　处：《中华创伤骨科杂志》2024年第11期972-977,共6页Chinese Journal of Orthopaedic Trauma

基　　金：广东省高水平医院建设专项经费(粤府办[2021]6号);深圳市"医疗卫生三名工程"项目资助(SZSM202011012)。

摘　　要：目的比较两种不同克氏针固定方式治疗儿童CampbellⅡ型(严重移位)近节指骨骨骺旁骨折的疗效。方法回顾性分析2018年1月至2020年12月在深圳市儿童医院骨科治疗的69例儿童CampbellⅡ型近节指骨骺旁骨折患儿资料。男41例,女28例;年龄(7.6±3.2)岁;左手34例,右手35例;拇指4例,中指4例,环指5例,小指56例。根据克氏针内固定方式不同分为2组:A组(35例35指采用闭合复位单枚克氏针纵向髓内固定联和石膏外固定治疗),B组(34例34指采用闭合复位2枚克氏针交叉固定联和石膏外固定治疗)。比较两组患儿术前骨折成角角度、手术时间、术后骨折成角角度、住院时间、术后功能恢复情况。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。所有患儿骨折均获愈合,愈合时间为3~6周。两组患儿在术前骨折成角角度、手术时间、术后骨折成角角度上差异无统计学意义(P>0.05)。A组患儿住院时间较B组短,差异有统计学意义(P<0.05)。50例患儿获(54.3±10.5)个月随访,其中A组24例,B组26例。末次随访时按手功能评定试用标准:A组优24例,优良率100%(24/24);B组优26例,优良率100%(26/26),差异无统计学意(P>0.05)。术后无一例患儿发生克氏针断裂、针道感染、明显成角畸形、旋转畸形、骨桥形成等并发症。结论对于儿童近节指骨CampbellⅡ型骨骺旁骨折,单枚克氏针纵向髓内固定与2枚克氏针交叉固定在骨折稳定性和功能方面效果相当,但前者患儿住院时间更短。ObjectiveTo compare 2 modalities of Kirschner pin fixation for severely displaced(Campbell typeⅡ)juxta-epiphyseal fracture of the proximal phalanx in children.MethodsA retrospective study was conducted to analyze the clinical data of 69 children with severely displaced(Campbell typeⅡ)juxta-epiphyseal fracture of the proximal phalanx who had been treated at Department of Orthopaedics,Shenzhen Children's Hospital from January 2018 to December 2020.Clinical data:41 boys and 28 girls;(7.6±3.2)years in age;34 left hands and 35 right hands affected;4 thumbs,4 middle fingers,5 ring fingers,and 56 little fingers injured.The patients were divided into 2 groups according to surgical modalities.Group A(35 fingers in 35 cases)was treated by closed reduction,longitudinal intramedullary fixation with a single Kirschner pin,and external plaster fixation while group B(34 fingers in 34 cases)by closed reduction,crossing fixation with 2 Kirschner pins,and external plaster fixation.The 2 groups were compared in terms of preoperative fracture angulation,operation time,postoperative fracture angulation,hospitalization days,and postoperative functional recovery.ResultsThere was no statistically significant difference in the preoperative general data between the 2 groups,indicating comparability(P>0.05).All fractures got united after 3 to 6 weeks.There was no statistically significant difference between the 2 groups in terms of preoperative fracture angulation,operation time,or postoperative fracture angulation(P>0.05).The hospitalization days in group A were significantly shorter than that in group B(P<0.05).Fifty children(24 cases in group A and 26 cases in group B)were followed up for(54.3±10.5)months.By the trial criteria for upper limb functional evaluation of the Hand Surgery Society,the hand function was evaluated at the last follow-up as excellent in 24 cases in group A,giving an excellent rate of 100%(24/24),and as excellent in 26 cases in group B,giving an excellent rate of 100%(26/26)too,showing no significant differen

关 键 词：儿童 指骨 骨折固定术 内 克氏针 骨骺旁骨折 

分 类 号：R726.8[医药卫生—儿科]