摘要
目的对比切开复位克氏针固定术与闭合复位弹性髓内钉固定术治疗小儿桡骨颈骨折的疗效与安全性。方法选取开封市儿童医院2015年3月—2020年3月收治的36例桡骨颈骨折患儿为研究对象,随机分为对照组和观察组各18例。对照组使用切开复位克氏针固定术进行治疗,观察组使用闭合复位弹性髓内钉固定术进行治疗。比较两组围术期基本情况(手术时间、术中出血量、住院时间),对比术前、术后3个月肘关节活动范围(肘关节旋后、旋前、屈、伸活动范围)及肘关节功能[Mayo肘关节功能评分(MEPS)],统计术后1个月内两组术后并发症。结果观察组手术时间、术中出血量、住院时间均低于对照组(P<0.05)。术后1个月内,两组术后并发症总发生率比较无统计学意义(P>0.05)。术后3个月,观察组肘关节旋后、旋前、屈、伸活动范围均高于对照组(P<0.05);两组疼痛、稳定性、运动、日常生活功能等MEPS评分较术前均有显著升高(P<0.05),且观察组明显高于对照组(P<0.05)。结论与切开复位克氏针固定术相比,闭合复位弹性髓内钉固定术治疗小儿桡骨颈骨折的疗效更显著,能加快患儿术后恢复,具有较高临床应用价值。
Objective To compare the efficacy and safety of open reduction Kirschner wire fixation and closed reduction elastic intramedullary nail fixation in the treatment of radial neck fractures in children.Methods Totally 36 children patients with radial neck fractures to the hospital between March 2015 and March 2020 were selected as the research subjects,and they were divided intocontrol group and observation group with 18 cases in each group according to the block randomization grouping method.Control group was treated with open reduction Kirschner wire fixation,while observation group was treated with closed reduction elastic intramedullary nail fixation.Theperioperative basic status(surgical time,intraoperative blood loss,hospital stay)were compared between the two groups.The ranges of elbow jointmotions(ranges of motions of elbow joint supination,pronation,flexion and extension)and elbow joint function[Mayo Elbow Performance Score(MEPS)]were compared before surgery and at 3 months after surgery.The postoperative complications were statistically analyzed in the two groups within 1 month after surgery.Results The surgical time,intraoperative blood loss and hospital stay inobservation group were shorter or less than those in control group(P<0.05).Within 1 month after surgery,there was no statistically significant difference in the total incidence rate of postoperative complications between the two groups(P>0.05).At 3 months after surgery,the ranges of motions of elbow joint supination,pronation,flexion and extension in observation group werelarger than those in control group(P<0.05).The MEPS scores of pain,stability,exercise and daily living function in the two groups were significantly increased compared with those before surgery(P<0.05),and the scores of observation group were significantly higher than those of control group(P<0.05).Conclusion Compared with open reduction Kirschner wire fixation,closed reduction elastic intramedullary nail fixation has a more significant efficacy in the treatment of radial neck fractures in children,and it can better speed up the postoperative recovery and has higher clinical application value.
作者
徐丰
郭春娜
XU Feng;GUO Chun-na(Department of Surgery,Kaifeng Children's Hospital,Kaifeng,Henan 475000,China)
出处
《医药论坛杂志》
2021年第20期68-70,74,共4页
Journal of Medical Forum
关键词
切开复位克氏针固定术
闭合复位弹性髓内钉固定术
桡骨颈骨折
Open reduction Kirschner wire fixation
Closed reduction elastic intramedullary nail fixation
Radial neck fractures
