| 方晶晶,马国杰.经皮克氏针撬拨复位辅助弹性髓内钉固定治疗Judet Ⅲ～Ⅳ型儿童桡骨颈骨折疗效分析[J].中国烧伤创疡杂志,2020,(6):422~425. |
| DOI： |
| 中文关键词: 弹性髓内钉 克氏针 内固定 桡骨颈骨折 儿童 复位质量 肘关节功能 |
| 英文关键词:Elastic stable intramedullary nail Kirschner wire Internal fixation Radial neck fracture Children Reduction quality Elbow joint function |
| 基金项目: |
|
| 摘要点击次数: 1630 |
| 全文下载次数: 4079 |
| 中文摘要: |
| 【摘要】目的 对比分析经皮克氏针撬拨复位辅助弹性髓内钉固定治疗Judet Ⅲ～Ⅳ型儿童桡骨颈骨折的临床疗效。方法 选取2014年6月至2017年6月鹤壁市人民医院收治的41例Judet Ⅲ～Ⅳ型儿童桡骨颈骨折患儿作为研究对象，并按照入院顺序单双号将其分为观察组（2l例）与对照组（20例），观察组患儿采用经皮克氏针撬拨复位辅助弹性髓内钉固定治疗，对照组患儿采用经皮克氏针内固定治疗，对比两组患儿手术时间，术中出血量，复位质量，肘关节功能评分，患肢活动功能以及骨骺早闭、桡骨头坏死等并发症发生情况。结果 观察组患儿手术时间明显长于对照组（t=7.850，P=0.000），术中出血量明显多于对照组（t=7.843，P=0.000），肘关节功能评分明显高于对照组（t=7.289，P=0.000），复位质量及并发症发生情况与对照组无明显差异（复位质量：Z=-1.593，P=0.111；并发症发生情况：χ2=2.208，P=0.137）；观察组患儿前臂旋前、旋后及提携角度恢复情况明显优于对照组（t=3.210、4.822、9.160，P=0.003、0.000、0.000）。结论 在儿童桡骨颈骨折治疗中，经皮克氏针内固定的创伤更小，但经皮克氏针撬拨复位辅助弹性髓内钉固定对肘关节功能及患肢活动功能的恢复效果更佳，值得临床进一步行大样本深入研究探讨。 |
| 英文摘要: |
| 【Abstract】Objective To compare and analyze the curative effect of percutaneous K-wire prying reduction followed by fixation with elastic stable intramedullary nailing in the treatment of children patients’ radial neck fracture (Judet?type III?or?IV?). Methods Forty-one children patients with Judet Ⅲ-Ⅳ radial neck fractures, admitted to The People's Hospital of Hebi from June 2014 to June 2017, were selected as research subjects, and they were divided, according to the odevity of their admission number, into an observation group (21 cases) and a control group (20 cases). The patients in the observation group were treated with percutaneous K-wire prying reduction followed by fixation with elastic stable intramedullary nailing, whereas patients in the control group were treated with the percutaneous K-wire internal fixation simply. The following indexes of patients were compared between the two groups including operation time, intraoperative blood loss, reduction quality, elbow joint function score, movement function of the affected limb, and incidence of complications such as early closure of epiphysis, necrosis of radial head. Results The operation time in the observation group was significantly longer than that in the control group (t=7.850, P=0.000), the intraoperative blood loss in the observation group was obviously more than that in the control group (t=7.843, P=0.000), and the elbow joint function score in the observation group was significantly higher than that in the control group ( t=7.289, P=0.000), but no significant differences were found in reduction quality and the occurrence of complications between the two groups (reduction quality: Z=-1.593, P=0.111; occurrence of complications: χ2=2.208, P=0.137). The recovery condition of forearm pronation, supination and carrying angle in the observation group were significantly better than that in the control group (t=3.210, 4.822 and 9.160 respectively, P=0.003, 0.000, and 0.000 respectively). Conclusion In the treatment of radial neck fracture in children patients, the therapy of percutaneous K-wire internal fixation was minimally invasive, but the percutaneous K-wire prying reduction followed by fixation with elastic stable intramedullary nailing has a better effect on recovering elbow joint function and movement function of affected limbs, which could be further explored by developing large scale clinical studies. |
|
|
|
|
