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主管:陕西省卫生健康委员会
主办:西安心身医学研究所
   西安交通大学第一附属医院
国际标准刊号:ISSN2096—1413
国内统一刊号:CN61—1503/R

闭合复位弹性髓内钉固定治疗儿童6周以内桡骨陈旧性骨折临床疗效分析

潘琪1,罗冬冬2

(1. 中国兵器工业第202 研究所职工医院,陕西 咸阳,712000;2.咸阳市中心医院,陕西 咸阳,712000)

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摘要:

目的 探讨闭合复位弹性髓内钉固定治疗儿童6周以内桡骨陈旧性骨折的疗效。方法 选取6周以内桡骨陈旧性骨折患儿24例,全身麻醉或臂丛麻醉后,按照弹性钉置入要求依次锥孔,伸入预弯的弹性钉。透视下观察尺骨骨折,其中6例患儿的尺骨位置理想,周围可见骨痂,未作特殊处理;10例患儿存在成角移位,以处理桡骨骨折同样的方法处理尺骨,用弹性髓内钉固定;8例患儿切开清理骨痂,重新复位后采用接骨板固定。所有患儿术后行长臂石膏托外固定。结果 所有患儿均获得 随访,平均随访时间(14.0±3.2)月。均在术后10~14 d拆线。平均骨折临床愈合时间为(11.5±1.1)周,平均取出内固定时间(8.5±0.6)月。无骨折延迟愈合、畸形愈合,无骨骺损伤,无腕、肘关节功能受限,无骨筋膜室综合症、骨化性肌炎等并发症发生。按Anderson评价标准,治疗效果优15例,良8例,可1例。结论 闭合复位弹性髓内钉固定治疗儿童6周以内桡骨陈旧性骨折,具有简单、微创、不留明显瘢痕的优点,可作为治疗短时间桡骨陈旧性骨折的一种选择。

关键词:闭合复位;弹性髓内钉;桡骨陈旧性骨折

中图分类号:R726.8文献标志码:A文章编号:2096-1413(2017)27-0001-02

    Curative effect analysis of the closure reposition and elastic intramedullary nail fixation treatment in children with radial old fracture within 6 weeks
    PAN Qi 1, LUO Dong-dong 2
    (1. Worker``s Hospital of No.202 Research Institute of China Ordnance Industry, Xianyang 712000; 2. Xianyang Central Hospital, Xianyang 712000, China)

    ABSTRACT: Objective To study the curative effect of the closure reposition and elastic intramedullary nail fixation treatment in children with radial old fracture within 6 weeks. Methods There were 24 cases of children with radial old fracture within 6 weeks. After general anesthesia or after brachial plexus anesthesia, bore-hole was made according to the requirements of elastic nailing, and the pre-curved elastic nail were extended into bore-hole. The fracture of ulna was observed by fluoroscopy, the ulnar position of the 6 cases was ideal, and surrounded by bony callus without special treatment; there were angular displacement in 10 cases, who were treated in the same way as the radius fracture, and the ulnas were fixed with elastic screw; 8 cases of children were treated with incision and debridement of callus, and the ulnas were fixed after reset. All the children were treated with long arm plaster external fixation. Results All the children were followed up, and the mean follow-up time was (14.0±3.2) months, and all stitches were removed at 10-14 d after operation. the mean fracture healing time was (11.5±1.1) weeks. The average removal of internal fixation time was (8.5±0.6) months. There were no complications such as delayed union, malunion, epiphyseal injuries, functional limitations of wrist and elbow, compartment syndrome, myositis ossificans, etc. According to the Anderson evaluation criteria, the treatment effects were excellent in 15 cases, good in 8 cases, and acceptable in 1 cases. Conclusion Closure reposition and elastic intramedullary nail fixation for the treatment of old fractures of radius within 6 weeks in children has the ad vantages of simplicity, minimal invasion and no obvious scar. It can be used as an option for the treatment of short period of old fractures of radius
    KEYWORDS: closure reposition; elastic intramedullary nail; old fractures of radius

    参考文献:
    [1] LEE S,NICOL RO,STOTT NS.Intramedullary fixation for pediatric unstable forearm fractures[J].Clin Orthop Relat Res,2002,402(402):245-250.
    [2] CHAN CF,MEADS BM,NICOL RO.Remanipulation of forearm fractures in children[J].N Z Med J,1997,110(1047):249-250.
    [3] 罗冬冬,杨彬强,张智勇,等.闭合复位弹性髓内针内固定治疗儿童不稳定尺桡骨骨折[J].中国骨与关节损伤杂志,2015,30(1):99-100.
    [4] 王阳,潘进社.骨折愈合相关因素的研究进展[J].中国矫形外科杂志,2012,20(8):724-726.

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