摘要
目的探究骨骺位移率与儿童桡骨骨骺端骨折复位后腕关节功能恢复的关系。方法回顾性分析自2017年1月至2020年1行保守治疗的符合桡骨远端Salter-HarrisⅠ、Ⅱ型骨折的患儿共23例,在复位前、复位后即刻、末次随访时使用PACS图文分析系统测量患腕的正位骨骺位移率、侧位骨骺位移率、尺骨变异、桡骨高度、掌倾角、尺偏角,末次随访时进行腕关节功能评分。结果本组23例患儿均获得随访,时间为7~12个月,平均9.9个月。末次随访摄X线片示骨折均临床愈合。影像学资料结果表明尺骨变异在复位前、复位后无差异(P=0.34);其余患腕各测量指标复位后结果均优于复位前、末次随访优于复位后,差异均有统计学意义(P<0.05)。末次随访采用改良Gartland-Werley腕关节功能评分评价患腕关节功能:优20例,良3例。复位后腕关节功能为优的患者正位骨骺位移率<4.9%、侧位骨骺位移率<9.5%、尺骨变异<2.6 mm,桡骨高度>7.0 mm、掌倾角>7.70,尺偏角>15.1°。末次随访改良Gartland-Werley腕关节功能评分与复位后正位骨骺位移率、侧位骨骺位移率桡骨高度以及掌倾角具有相关性,并且相关性从侧位骨骺位移率、掌倾角、桡骨高度、正位骨骺位移率依次递减。结论骨骺位移率可以量化残留位移的程度,用于评价儿童骨骺骨折的复位效果,复位后残留的骨骺位移率与腕关节功能具有相关性,可为临床诊疗提供可靠依据,具有临床应用价值。
Objective To explore the relationship between epiphyseal displacement rate and wrist function recovery after reduction of radial epiphyseal fracture in children.Methods A total of 23 children with Salter-Harris typeⅠandⅡfractures of the distal radius who underwent conservative treatment from January 2017 to January 2020 were retrospectively analyzed.The positive epiphysis displacement rate,lateral epiphysis displacement rate,ulnar variation,radius height,palmar inclination angle and ulnar deviation angle of the affected wrist were measured by graphic analysis system(PACS)before reduction,immediately after reduction and at the last follow-up.The wrist function score was performed at the last follow-up.Results All the 23 children were follow-up for 7 to 12 months,with an average of 9.9 months.X-ray films taken at the last follow-up showed that all fractures healed clinically.The results of radiographic data showed that there was no difference in ulna variation before and after reduction(P=0.34).The results of other wrist measurements after reduction were better than those before reduction and those at the last follow-up were better than after reduction,with the difference being statistically significant(P<0.05).At the last follow-up,the modified Gartland-Werley wrist function score was used to evaluate the wrist function,and the results rated as excellent in 20 cases,good in 3 cases.After reduction,patients with excellent wrist function had positive epiphysis displacement rate<4.9%,lateral epiphysis displacement rate<9.5%,ulna variation<2.6 mm,radius height>7.0 mm,palmar inclination>7.7°,ulnar deviation>15.1.At the last follow-up,modified Gartland-Werley wrist function score was correlated with the positive epiphysis displacement rate,lateral epiphysis displacement rate,radius height and palmar inclination after reduction,and the correlation decreased in turn from lateral epiphysis displacement rate,palmar inclination,radius height and positive epiphysis displacement rate.Conclusion The epiphyseal displacement
作者
杜惠群
邢春苗
田永申
刘康
徐佳俊
蔡盐东
龚炎培
Du Huiqun;Xing Chunmiao;Tian Yongshen;Liu Kang;Xu Jiajun;Cai Yandong;Gong Yanpei(Department of Orthopedics,Eastern Theater Command General Hospital,Nanjing210002,China;Department of Hand Surgery,Affiliated Hospital of Nantong University,Nantong 226006,China;Department of Orthopedics,People'Hospital of Rugao,Rugao 226599,China;Medical Srvice Center of Nantong University,Nantong 226006,China)
出处
《中华手外科杂志》
CSCD
北大核心
2023年第1期15-18,共4页
Chinese Journal of Hand Surgery
关键词
桡骨骨折
儿童
骨骺
影像学指标
功能评价
Radius fractures
Child
Epiphyses
Radiographic index
Functional assessment
