闭合复位弹性髓内钉固定治疗儿童不稳定桡骨远端骨折伴尺骨骨折的疗效分析  

Analysis of curative effect of closed reduction and elastic intramedullary nail fixation on children with unstable distal radius fracture and ulna fracture

作　　者：邓斌 孙少松 DENG Bin;SUN Shao-song(Department of Orthopedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院骨科,221000

出　　处：《中国现代药物应用》2025年第2期41-44,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探讨在儿童不稳定桡骨远端骨折伴尺骨骨折治疗中应用闭合复位弹性髓内钉固定的临床效果。方法 46例不稳定桡骨远端骨折伴尺骨骨折患儿,按照骨折固定手术方式的不同分为观察组(行闭合复位弹性髓内钉固定治疗,23例)、对照组(行切开复位钢板内固定治疗,23例)。比较两组手术及预后情况,疼痛评分,前臂旋转功能和腕关节活动改善效果,术后并发症发生率。结果 观察组术中出血量、手术时间、切口大小、术后骨折愈合时间分别为(43.16±9.53)ml、(49.37±10.89)min、(3.86±1.79)cm、(31.27±5.64)d,对照组分别为(89.64±12.43)ml、(60.64±11.74)min、(8.97±2.35)cm、(35.86±7.32)d。与对照组相比,观察组术中出血量和切口大小更小,手术时间及术后骨折愈合时间更短,差异有统计学意义(P<0.05)。两组术后7 d视觉模拟评分法(VAS)评分均较术前降低,且观察组术后7 d VAS评分(3.85±1.59)分低于对照组的(5.12±1.81)分,差异有统计学意义(P<0.05)。观察组前臂旋转功能和腕关节活动的改善优良率分别为95.65%、100.00%,均高于对照组的73.91%、78.26%,差异有统计学意义(P<0.05)。观察组术后并发症发生率8.70%略低于对照组的17.39%,但差异无统计学意义(P>0.05)。结论 在儿童不稳定桡骨远端骨折伴尺骨骨折中,应用闭合复位弹性髓内钉固定治疗的创伤更小,愈合更快,且有利于前臂旋转功能和腕关节活动能力的恢复。Objective To explore the clinical effect of closed reduction and elastic intramedullary nail fixation on children with unstable distal radius fracture and ulna fracture.Methods 46 children with unstable distal radius fracture and ulna fracture were divided into observation group(closed reduction and elastic intramedullary nail fixation,23 cases) and control group(open reduction and internal plate fixation,23 cases) according to different methods of fracture fixation.The surgery and prognosis,pain score,improvement of forearm rotation function and wrist joint mobility,and postoperative complication rate were compared between the two groups.Results The intraoperative blood loss,operation time,incision size and postoperative fracture healing time of the observation group were(43.16±9.53) ml,(49.37±10.89) min,(3.86±1.79) cm and(31.27±5.64) d,and those of the control group were(89.64±12.43) ml,(60.64±11.74) min,(8.97±2.35) cm and(35.86±7.32) d.Compared with the control group,the intraoperative blood loss and incision size in the observation group were smaller,and the operation time and the postoperative fracture healing time were shorter.There was statistical significance(P<0.05).At 7 d after surgery,the visual analogue scale(VAS) score in both groups was lower than that before surgery,and VAS score of(3.85±1.59) points in the observation group was lower than(5.12±1.81) points in the control group.There was statistical significance(P<0.05).The excellent rates of forearm rotation function and wrist joint mobility in the observation group were 95.65% and 100.00%,which were higher than 73.91% and 78.26% in the control group,and there was statistical significance(P<0.05).The incidence of postoperative complications in the observation group(8.70%) was slightly lower than that in the control group(17.39%),but the difference was not statistically significant(P>0.05).Conclusion In children with unstable distal radius fractures and ulna fractures,the use of closed reduction and elastic intramedullary nail fixation ha

关 键 词：闭合复位弹性髓内钉固定 不稳定桡骨远端骨折 尺骨骨折 儿童 

分 类 号：R726.8[医药卫生—儿科]