摘要
目的探讨髓内外联合固定治疗儿童桡骨远端干骺端移行部骨折的疗效。方法回顾性分析2018年7月至2020年4月西安交通大学附属红会医院儿童骨病医院收治的49例桡骨远端干骺端移行部骨折患儿资料。男30例, 女19例;左侧21例, 右侧27例, 双侧1例。手术选择使用弹性髓内钉或克氏针进行髓内固定, 再使用另1枚克氏针固定骨折远、近两端双层皮质。记录并比较术后1、9个月腕关节活动度和上肢功能障碍评分(DASH), 同时记录术后并发症发生情况。结果 49例骨折患儿手术时间平均为45.0 min(39~51 min)。术后获6~36个月(平均18.6个月)随访。骨折愈合时间平均8.6周(6.8~10.4周)。1例出现针道感染, X线片示骨痂生成, 拔出克氏针后口服抗菌素3 d, 伤口痊愈。1例发生皮肤激惹, 患儿减少活动后症状消失。术后1个月腕关节旋前、旋后、屈腕、伸腕活动度及DASH分别为47.9°±2.5°、45.5°±3.0°、51.2°±1.6°、53.4°±1.7°、(36.7±4.5)分, 术后9个月分别为85.6°±3.1°、87.6°±2.1°、88.8°±2.0°、88.0°±1.2°、(23.2±8.6)分, 以上指标术后1、9个月比较, 差异均有统计学意义(P<0.05)。结论髓内外联合固定治疗儿童桡骨远端干骺端移行部骨折, 手术操作技术简单, 可重复性强, 创伤小, 固定效果可靠。
Objective To investigate the efficacy of intramedullary plus extramedullary fixation in the treatment of fractures of distal radial diametaphyseal transition zone in children.Methods The data were retrospectively analyzed of the 49 children who had been admitted to Pediatric Orthopedic Hospital,Honghui Hospital Affiliated to Xi'an Jiaotong University from July 2018 to April 2020 for fractures of distal radial diametaphyseal transition zone.There were 30 males and 19 females;21 left sides,27 right sides,and one case of bilateral sides.In the operation,an elastic intramedullary nail or Kirschner wire was used for intramedullary fixation while another Kirschner wire was used to fix the cortex at the distal and proximal ends of the fracture.The ranges of wrist motion and Disabilities of the Arm,Shoulder and Hand(DASH)scores at 1 and 9 months after operation were recorded and compared;the incidence of postoperative complications was also recorded.Results The operation time for the 49 children averaged 45.0 min(from 39 to 51 min).The patients were followed up for 6 to 36 months(mean,18.6 months).The fracture union time averaged 8.6 weeks(from 6.8 to 10.4 weeks).Needle tract infection developed in one case but the wound was healed after removal of the K-wire after callus formation and oral use of antibiotics for 3 days.Another case reported skin irritation the symptoms of which disappeared after the child reduced activities.The ranges of pronation,supination,flexion and extension of the wrist and DASH score were 47.9°±2.5°,45.5°±3.0°,51.2°±1.6°,53.4°±1.7°and(36.7±4.5)points at one month after operation while they were 85.6°±3.1°,87.6°±2.1°,88.8°±2.0°,88.0°±1.2°and(23.2±8.6)points at 9 months after operation.There were statistically significant differences in the above indexes between one and 9 months after operation(P<0.05).Conclusion In the treatment of fractures of distal radial diametaphyseal transition zone in children,intramedullary plus extramedullary fixation is simple in surgical techni
作者
李敏
颉强
陆清达
梁小菊
屈继宁
汪兵
孟海亮
杨亚婷
Li Min;Jie Qiang;Lu Qingda;Liang Xiaoju;Qu Jining;Wang Bing;Meng Hailiang;Yang Yating(Pediatric Orthopedic Hospital,Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710056,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第5期452-455,共4页
Chinese Journal of Orthopaedic Trauma
基金
国家自然科学基金面上项目(81871743)
陕西省创新能力支撑计划项目-临床研究中心(2020LCZX-03)
陕西省创新能力支撑计划-骨骼遗传与发育畸形研究创新团队(2020TD-036)。
关键词
儿童
骨折固定术
桡骨骨折
干骺端移行部
Child
Fracture fixation
Radius fractures
Diametaphyseal transition zone
