术中肘关节造影引导下闭合撬拨复位治疗低龄儿童桡骨颈骨折  

Closed prying reduction guided by elbow arteriography for treatment of radial neck fracture in young children

作　　者：孙涛 张健 慕明章 栾景杰 唐伟 Sun Tao;Zhang Jian;Mu Mingzhang;Luan Jingjie;Tang Wei(Department of Pediatric Orthopedics,Yantaishan Hospital,Yantai 264003,China;Institute of Orthopedics,the Fourth Medical Center of the Chinese People’s Liberation Army General Hospital,Beijing 100048,China;Department of Trauma Orthopedics,Yantaishan Hospital,Yantai 264003,China)

机构地区：[1]烟台山医院小儿骨科,烟台264003 [2]中国人民解放军总医院第四医学中心骨科研究所,北京100048 [3]烟台山医院创伤骨科,烟台264003

出　　处：《中华实验外科杂志》2025年第1期138-140,共3页Chinese Journal of Experimental Surgery

基　　金：山东省医药卫生科技发展计划项目(202004070408)。

摘　　要：目的探讨术中肘关节造影在低龄儿童桡骨颈骨折中的应用价值。方法回顾性分析2018年7月至2023年7月在烟台市烟台山医院行手术治疗的60例桡骨头未显影或显影不完全的桡骨颈骨折患儿,其中男24例,女36例,患儿年龄3.58~6.83岁,平均5.48岁,将患儿按照等距抽样方法分为术中造影组30例与术中未造影组30例,采用显著性差异P值分析对比两组患儿术中三维C型臂透视机透视次数、手术时间长短、末次随访时X线片评分(依据X线的Metaizeau评分标准)、末次随访时肘关节功能评分(依据Steele功能评分标准)。组间比较采用独立样本t检验,等级资料组间比较采用秩和检验,计数资料组间比较采用χ2检验。结果术中透视次数比较,造影组[(18.10±3.03)次]低于未造影组[(26.20±4.24)次,t=8.482,P<0.01];造影组手术时间[(23.00±5.37)min]低于未造影组[(36.00±4.35)min,t=10.337,P<0.01]。造影组患儿X线的角度恢复情况优良率稍高于未造影组(29/30比27/30,Z=0.643,P>0.05),但两组之间差异无统计学意义。造影组患儿肘关节功能优良率稍高于未造影组(29/30比28/30,Z=0.634,P>0.05),但两组之间差异无统计学意义。结论肘关节造影能很好显示低龄儿童桡骨头骨骺形态,减少患儿辐射接受量,有效缩短手术时间,提高手术效果。Objective To investigate the application value of intraoperative elbow arthrography in young children with radial neck fracture.Methods A retrospective analysis was performed on 60 children with non-radial-head or incomplete radial-neck fracture who underwent surgical treatment in Yantaishan Hospital from July 2018 to July 2023,including 24 males and 36 females,with an average age of 5.48 years from 3.58 to 6.83 years.The children were divided into the intraoperative angiography group(30 cases)and the non-angiography group(30 cases)according to isometric sampling method.Significant difference P-value analysis was used to compare the number of intraoperative 3D C-arm fluoroscopy,length of operation,radiographic score at the last follow-up(according to the Metaizeau scale of X-ray),and elbow joint function score at the last follow-up(according to the Steele scale of function)of the two groups.The t test of independent samples was used for comparison between groups.Rank sum test was used to compare rank data groups.Chi-square test was used to compare the data groups.Results The intraoperative fluoroscopy times in contrast group[(18.10±3.03)]were less than those in non-contrast group[(26.20±4.24),t=8.482,P<0.01].The operation time in contrast group[(23.00±5.37)min]was shorter than that in non-contrast group[(36.00±4.35)min,t=10.337,P<0.01].The excellent and good rate of X-ray angle recovery in the angiography group was slightly higher than that in the non-angiography group(29/30 vs.27/30,Z=0.643,P>0.05),but there was no statistically significant difference between the two groups.The excellent and good rate of elbow joint function in the angiography group was slightly higher than that in the non-angiography group(29/30 vs.28/30,Z=0.634,P>0.05).Conclusion Elbow arthrography can well display the morphology of radial head epiphysis in young children,reduce the amount of radiation received by children,effectively shorten the operation time and improve the operation effect.

关 键 词：低龄儿童 桡骨颈骨折 肘关节造影 闭合复位 

分 类 号：R726.8[医药卫生—儿科]