摘要
目的总结分析9例儿童Salter-HarrisⅡ型指骨骨折的临床疗效。方法 2018年1月-2019年2月,采用有限切开复位及闭合复位经皮克氏针内固定结合石膏外固定治疗儿童指骨骨折9例9指。术前经X线片确诊,骨折均为闭合性新鲜骨折,根据骺板损伤的Salter-Harris分型,均为Ⅱ型。术后2、4、6周定期复查X线片观察骨折愈合情况。结果术后所有患儿均获得随访,时间为3~16个月,平均8个月。1例术后发生迟发性畸形及骨骺早闭,其余8例均获得愈合,平均愈合时间4周,愈合后外观无明显成角及旋转畸形,无切口感染、克氏针松动、针道感染、关节僵硬及肌腱粘连等并发症。按中华医学会手外科学会上肢部分功能评定标准评定:优7例,良1例,差1例。结论在掌握适应证的前提下,有限切开复位或闭合复位经皮克氏针结合石膏外固定治疗儿童Salter-HarrisⅡ型指骨骨折,均能获得满意的效果,但对于合并软组织损伤尤其邻近骨折处发生软组织感染的病例,需要引起高度重视,有导致永久性畸形和功能障碍风险。
Objective To sumarize and analyze the clinical outcomes in the treatment of Salter-Harris type Ⅱ phalangeal fracture in children. Methods From January 2018 to February 2019, 9 cases(9 fingers)of pediatric phalangeal fractures were treated by limited open reduction and closed reduction combined with Kirschner wire internal fixation and plaster external fixation.The preoperative X-ray showed that the fractures are closed fresh fractures.According to the Salter-Harris classification,all the fractures were typeⅡ. X-ray examination was performed at 2, 4 and 6 weeks after operation to observe fracture healing.Results All the patients were followed up for 3 to 16 months, with an average of 8 months. One patient developed delayed malformation and epiphyseal premature closure after surgery, and the other 8 patients healed, with an average healing time of 4 weeks. There were no obvious angle formation and rotation malformation, no incision infection, kirschner wire loosening, needle tract infection, joint stiffness, tendon adhesion and other complications. According to the standards of upper limb function evaluation of Chinese society of hand surgery, the results were excellent in 7 cases, good in 1 case, poor in 1 case.Conclusion Under the premise of mastering the indications, limited open reduction or close reduction combined with plaster external fixation for the treatment of Salter-Harris Ⅱ phalangeal fractures in children can obtain satisfactory results, but for the cases of soft tissue injuries especially fracture adjacent soft tissue infection, we have to be careful,because there are risks to permanent deformity and dysfunction.
作者
庞波涛
宋坤修
马丙栋
刘永涛
PANG Botao;SONG Kunxiu;MA Bingdong(Department of Hand Microsurgery,Hospital Affiliated to Binzhou Medical College,Binzhou,Shandong,256600,China)
出处
《实用手外科杂志》
2019年第4期410-412,共3页
Journal of Practical Hand Surgery
