超声辅助闭合复位技术在儿童O'Brien Ⅱ、Ⅲ型桡骨颈骨折治疗中的临床应用  

Ultrasound-assisted closed reduction for O’Brien type Ⅱ and Ⅲ radial neck fractures in children

作　　者：宋志杰[1] 彭丽星 沈洁 顾耘宇 梁祝英 Song Zhijie;Peng Lixing;Shen Jie;Gu Yunyu;Liang Zhuying(Department of Emergency Trauma Surgery,Kunming Children’s Hospital,Kunming 650032,China)

机构地区：[1]昆明市儿童医院急诊创伤外科,昆明650032

出　　处：《创伤外科杂志》2025年第1期38-42,共5页Journal of Traumatic Surgery

摘　　要：目的 介绍一种超声辅助闭合复位技术并探讨其在治疗儿童桡骨颈骨折中的疗效。方法 回顾性分析2020年8月—2022年8月昆明市儿童医院急诊创伤外科收治的30例O'BrienⅡ、Ⅲ型儿童桡骨颈骨折资料,男性19例,女性11例;年龄4~12岁,平均8.6岁;左侧13例,右侧17例;致伤原因均为跌倒;根据O'Brien分型,Ⅱ型12例、Ⅲ型18例。30例均采用术中超声定位下辅助闭合复位和弹性髓内针固定治疗。统计人口学资料和临床资料,包括年龄、性别、手术时间、骨折愈合时间和并发症。根据Metaizeau评价标准评价复位效果和并发症情况评价手术疗效。结果 30例均成功行超声辅助闭合复位,平均手术时间(31.0±4.6)min,骨折愈合时间(5.0±1.0)周,Metaizeau评价28例为优,2例为良;无一例出现桡骨头坏死、神经损伤、骨骺早闭;1例出现针尾激惹,取出内固定后门诊随访愈合良好。结论 超声作为一种无辐射、可重复的无创技术,可辅助复位儿童桡骨颈骨折,疗效满意,并且兼具微创、操作方便等优点。Objective To introduce an ultrasound-assisted closed reduction technique and evaluate its effectiveness in the treatment of pediatric radial neck fractures of O’Brien typesⅡandⅢ.Methods A retrospective analysis was carried out on the data of 30 children with O’Brien typeⅡandⅢradial neck fractures who underwent emergency trauma surgery at Kunming Children’s Hospital from Aug.2020 to Aug.2022.There were 19 males and 11 females aged 4-12(mean 8.6)years.Thirteen cases involved the left side and 17 the right.All of them were injured due to falls.According to O’Brien’s classification,12 cases were of typeⅡand 18 of typeⅢ.All the 30 cases underwent ultrasound-assisted closed reduction and elastic intramedullary nail fixation.Demographic and clinical data,including age,gender,surgery time,fracture healing time,and complications,were analyzed.Postoperative data were evaluated based on the Metaizeau evaluation criteria to assess the reduction effect,as well as complications to judge the surgical efficacy.Results The ultrasound-assisted closed reduction was successfully conducted on all the 30 cases,with the surgery time being(31.0±4.6)min and fracture healing time(5.0±1.0)weeks.The Metaizeau technique indicated excellent results in 28 cases,and good results in 2 cases,without any radial head necrosis,nerve injury,or epiphyseal premature closure.One case had needle tail irritation,which achieved good healing at outpatient follow-up after removal of the internal fixation.Ultrasound,as a non-invasive and reproducible technique,can assist in the reduction of radial neck fractures in children.It not only shows satisfactory surgical results but also has the advantages of minimal invasion and simple surgical operations.

关 键 词：桡骨颈骨折 超声辅助 闭合复位 弹性髓内针 儿童 

分 类 号：R683.41[医药卫生—骨科学]