弹性髓内钉闭合盲插法治疗儿童桡骨颈骨折疗效观察

摘要

Objective To investigate the curative effect of the minimally invasive treatment of radial neck fracture in children with elastic stable intramedullary nails. Methods From January 2013 to December 2016,57 children with radial neck fractures were treated in Ningbo women &children's hospital,including 38 cases of type Ⅱ,19 cases of type Ⅲ. Surgical indications existed in all cases with Metaizeau's technique(5 cases of Patterson/Israeli's technique). Postoperative function was evaluated according to the standard Metaizeau's technique for curative evaluation effect. Results All patients were followed up for 1 to 12 months,all fractures had healed.The x-ray showed angular deformity<20°,forearm pronation and supination>60°,better in 48 cases (84.2％),good in 9 cases (15.8％). 6 cases(10.5％)appeared skin irritation response,5 cases(8.8％) of postoperative radial nerve injury got improvement with symptomatic treatment,1 case(1.8％)of radial head overgrowth without elbow flexion and extension dyskinesia. Conclusions The minimally invasive treatment of radial neck fracture in children with elastic stable intramedullary nails, compared to the traditional operation,has many advantages,such as stable effect,simple operation,less trauma and minor complications.It is an ideal method in treatment of radial neck fracture in children.%目的 观察弹性髓内钉闭合盲插法治疗儿童桡骨颈骨折的临床疗效.方法 回顾性分析2013年1月至2016年12月57例Ⅱ型、Ⅲ型桡骨颈骨折的临床资料,其中Ⅱ型38例、Ⅲ型19例.所有患儿均存在手术指征,予以Metaizeau法弹性髓内钉复位固定(5例Patterson/Israeli技术辅助复位).按Metaizeau法疗效评定标准评定术后功能.结果 术后随访1～12个月,检查桡骨头稳定性及活动度,所有患儿髓内钉固定桡骨头牢固,骨折骨性愈合,前臂旋前旋后>60°,复查X线摄片成角<20°,评定良好48例(84.2％)、较好9例(15.8％).其中6例(10.5％)出现局部皮肤激惹反应,皮下滑囊形成,5例(8.8％)术后出现桡神经损伤症状,经甲钴胺肌注治疗后好转,1例(1.8％)出现桡骨头过度生长,未影响肘部屈伸旋转活动.结论 弹性髓内钉闭合盲插法治疗儿童桡骨颈骨折,相对于传统术式复位,其手术效果稳定,操作较简便,术后并发症少,是一种较为理想的治疗儿童桡骨颈骨折的方法.