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[1]明曉鋒,陳登山,張曉強(qiáng).閉合復(fù)位彈性髓內(nèi)釘固定和經(jīng)皮克氏針撬撥復(fù)位固定 治療兒童O'BrienⅡ、Ⅲ型橈骨頸骨折的療效比較[J].中醫(yī)正骨,2016,28(02):15-19.
　MING Xiaofeng,CHEN Dengshan,ZHANG Xiaoqiang.A clinical comparison of closed reduction and internal fixation with elastic intramedullary nails versus percutaneous leverage reduction and internal fixation with Kirschner wire for treatment of O'Brien typeⅡandⅢradial neck fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(02):15-19.
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閉合復(fù)位彈性髓內(nèi)釘固定和經(jīng)皮克氏針撬撥復(fù)位固定 治療兒童O'BrienⅡ、Ⅲ型橈骨頸骨折的療效比較()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年02期
頁碼:
15-19
欄目:
臨床研究
出版日期:
2016-02-20

文章信息/Info

Title:
A clinical comparison of closed reduction and internal fixation with elastic intramedullary nails versus percutaneous leverage reduction and internal fixation with Kirschner wire for treatment of O'Brien typeⅡandⅢ radial neck fractures in children
作者:
明曉鋒; 陳登山; 張曉強(qiáng)
河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 鄭州 450016
Author(s):
MING Xiaofeng; CHEN Dengshan; ZHANG Xiaoqiang
Luoyang Orthopedic-Traumatological Hospital,Zhengzhou 450016,Henan,China
關(guān)鍵詞:
橈骨骨折;  橈骨頸;  兒童;  外科手術(shù); 微創(chuàng)性;  髓內(nèi)釘;  克氏針;  治療; 臨床研究性
Keywords:
radius fractures;  neck of radius;  child;  surgical procedures; minimally invasive;  intramedullary nails;  Kirschner wire;  therapies; investigational
摘要:
目的:比較閉合復(fù)位彈性髓內(nèi)釘固定和經(jīng)皮克氏針撬撥復(fù)位固定治療兒童O'BrienⅡ、Ⅲ型橈骨頸骨折的臨床療效。方法 :2010年5月至2014年10月收治218例O'BrienⅡ、Ⅲ型橈骨頸骨折患兒,102例采用閉合復(fù)位彈性髓內(nèi)釘固定治療(髓內(nèi)釘組)、 116例采用經(jīng)皮克氏針撬撥復(fù)位固定治療(克氏針組)。比較2組的手術(shù)時間、術(shù)中出血量、住院時間、總費用、骨折復(fù)位情況、 骨折愈合時間及肘關(guān)節(jié)功能。結(jié)果:2組患者的術(shù)中出血量、住院時間、骨折愈合時間比較,組間差異均無統(tǒng)計學(xué)意義 [(9.73±1.44)mL,(9.98±1.60)mL,t=-1.710,P=0.183;(6.64±1.03)d,(6.58±0.95)d,t=0.630,P=0.711; (42.45±3.53)d,(41.64±2.96)d,t=1.240,P=0.287]; 髓內(nèi)釘組的手術(shù)時間和總費用均大于克氏針組 [(33.34±2.48)min,(21.45±1.79)min,t=3.880,P=0.001;(10.05±0.61)萬元,(5.23±0.65)萬 元,t=79.470,P=0.000]。術(shù)后采用Metaizeau復(fù)位標(biāo)準(zhǔn)評定骨折復(fù)位情況,髓內(nèi)釘組優(yōu)69例、良29例、可4例,克氏針組優(yōu)74例、 良37例、可5例; 2組患者的骨折復(fù)位情況比較,差異無統(tǒng)計學(xué)意義(Z=-0.587,P=0.557); 術(shù)后6個月采用改良Broberg和Morrey 評分標(biāo)準(zhǔn)評定肘關(guān)節(jié)功能,髓內(nèi)釘組優(yōu)61例、良37例、可4例,克氏針組優(yōu)57例、良47例、可12例; 2組患者的肘關(guān)節(jié)功能比較, 差異無統(tǒng)計學(xué)意義(Z=-1.845,P=0.065)。結(jié)論:采用閉合復(fù)位彈性髓內(nèi)釘固定和經(jīng)皮克氏針撬撥復(fù)位固定治療兒童O'BrienⅡ、 Ⅲ型橈骨頸骨折,創(chuàng)傷均較小,均能使骨折獲得良好復(fù)位和固定,術(shù)后肘關(guān)節(jié)功能恢復(fù)較好,二者的療效相當(dāng),但采用經(jīng)皮克氏針 撬撥復(fù)位固定治療手術(shù)時間短、費用較低。
Abstract:
Objective:To compare the curative effect of closed reduction and internal fixation with elastic intramedullary nails versus percutaneous leverage reduction and internal fixation with Kirschner wire for the treatment of O'Brien typeⅡandⅢradial neck fractures in children.Methods:Two hundred and eighteen children with O'Brien typeⅡorⅢradial neck fractures were recruited from May 2010 to October 2014.One hundred and two children were treated with closed reduction and internal fixation with elastic intramedullary nails (intramedullary nails group),and 116 children were treated with percutaneous leverage reduction and internal fixation with Kirschner wire(Kirschner wire group).The operative time,blood loss,hospital stay,total expense,fracture reduction,fracture healing time and elbow joint function were compared between the 2 groups.Results:There was no statistical difference in blood loss,hospital stay and fracture healing time between the two groups(9.73+/-1.44 vs 9.98+/-1.60 ml,t=-1.710,P=0.183; 6.64+/-1.03 vs 6.58+/-0.95 days,t=0.630,P=0.711; 42.45+/-3.53 vs 41.64+/-2.96 days,t=1.240,P=0.287).The operative time and total expense of intramedullary nails group were greater than those of Kirschner wire group(33.34+/-2.48 vs 21.45+/-1.79 min,t=3.880,P=0.001; 100.5+/-6.1 vs 52.3+/-6.5 thousands Yuan,t=79.470,P=0.000).The fracture reduction were evaluated according to Metaizeau reduction standard after the surgery.Sixty-nine children obtained an excellent result,29 good and 4 fair in the intramedullary nails group; while 74 children obtained an excellent result,37 good and 5 fair in the Kirschner wire group.There was no statistical difference in fracture reduction between the two groups(Z=-0.587,P=0.557).The elbow joint function were evaluated according to improved Broberg-Morrey scoring standard at 6 months after surgery,Sixty-one children obtained an excellent result,37 good and 4 fair in the intramedullary nails group; while 57 patients obtained an excellent result,47 good and 12 fair in the Kirschner wire group.There was no statistical difference in the elbow joint function between the two groups(Z=-1.845,P=0.065).Conclusion:Both closed reduction internal fixation with elastic intramedullary nails and percutaneous leverage reduction internal fixation with Kirschner wire can lead to less injury,good results of reduction and fixtion and good elbow joint function for treatment of O'Brien typeⅡandⅢradial neck fractures in children.They are similar to each other in clinical curative effects,while the latter has such advantages as shorter operative time and less expense.

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通訊作者:明曉鋒 E-mail:[email protected]
更新日期/Last Update: 2016-04-30