摘要
背景:儿童肱骨髁上骨折为儿童常见的骨折之一,何种内固定修复方式能更好的修复髁上骨折仍存在争议。目的:比较克氏针内固定拉力螺钉及可吸收钉、棒内固定修复儿童肱骨髁上骨折与宿主的生物相容性及其效果差异。方法:2007年1月至2013年1月泸州医学院附属医院收治的246例肱骨髁上骨折接受克氏针内固定修复患者,同时检索万方医学、中国知网数据库相关内固定修复儿童肱骨髁上骨折文献,将植入物修复前、后肘关节运动范围和生物相容性进行评价,并与可吸收钉、棒内固定修复结果进行了对比。结果与结论:全部病例获得随访,随访时间6-36个月,平均18个月。246修复肱骨髁上骨折患者中,修复后Mayo肘关节功能评分标准,优194例,良48例,优良率98.4%。4例患儿发生<5°肘内翻,肘内翻发生率为1.63%。无其他不良反应。切开复位克氏针内固定治疗可以直视下进行骨折复位,在满意的骨折愈合基础之上能较好的恢复肘关节的功能。但也存在克氏针易松动、退针的可能,易造成骨折固定不稳。可吸收内固定材料内固定能达到满意的骨折复位及牢固的内固定效果。可吸收材料在体内可自行分解,对人体无明显不良反应,无需二期手术取出。骨折愈合效果肯定,不影响关节功能及骨骺发育。由于缺乏大样本的临床病例研究,无法充分反应可吸收内固定材料临床应用中是否会产生其他不良事件,远期结果仍需大量临床病例资料进行验证。
BACKGROUND：Humeral supracondylar fracture is a common fracture occurred in children.The selection of internal fixation for humeral supracondylar fracture remains controversial.OBJECTIVE：To compare the biocompatibility between internal fixation with Kirschner wire and bioabsorbable implants for humeral supracondylar fractures.METHODS：From January 2007 to January 2013,246 cases of humeral supracondylar fractures,from Affiliated Hospital of Luzhou Medical College,were treated by internal fixation with Kirschner wire.Meanwhile,the studies on internal fixation for treating supracondylar fracture of humerus in children were searched.Efficacy was evaluated by preoperative and postoperative elbow range of motion and the incidence of cubitus varus,and the results were statistically analyzed,and compared with other therapeutic methods.RESULTS AND CONCLUSION：All cases were followed up for 6-36 months,averagely 18 months.According to Mayo elbow performance score,function of the elbow joint was excellent in 194 cases,and good in 48 cases,with good and excellent rate being 98.4%.Four cases suffered〈 5° cubitus varus,with incidence rate of 1.63%.The internal fixation with Kirschner wire provided functional recovery of elbow joint,but the second stage operation was needed to pick out the wires.And it might be perplexed by Kirschner wire loosening or needle withdrawal,resulting in instable fixation.Bioabsorbable implants were effective in the treatment of supracondylar fracture of humerus.Bioabsorbable sticks would break down over time,without harming to human body or influencingimaging examination.Elbow function development of the epiphysis would not be affected.However,due to lack of large-sample observation,long-term effects of bioabsorbable implants for treating supracondylar fracture of humerus in children deserve further studies.
出处
《中国组织工程研究》
CAS
北大核心
2015年第26期4218-4222,共5页
Chinese Journal of Tissue Engineering Research
