摘要
目的探讨钛制弹性髓内钉治疗小儿尺桡骨不稳定骨折的临床效果。方法选取2018年2月至2019年12月浙江省杭州市萧山区中医院收治的85例小儿尺桡骨不稳定双骨折患儿,采用随机数字表法分为对照组(42例)和观察组(43例)。对照组采用钢板内固定治疗,观察组采用钛制弹性髓内钉治疗。比较两组患儿术前及术后3个月的前臂旋前、旋后角度,术前及术后1d的疼痛视觉模拟量表(visual analogue scale,VAS)评分。术后3个月采用Broberg-Morrey评分评价两组患儿的肘关节功能情况,并比较两组的并发症发生情况。结果术后3个月两组患儿的前臂旋前、旋后角度均明显高于术前(P<0.05),术前及术后组间比较差异均无显著性(P>0.05)。两组术前VAS评分比较差异无显著性(P>0.05),术后1d观察组VAS评分明显低于对照组,差异有显著性(P<0.05)。Broberg-Morrey肘关节功能评分显示,术后3个月时观察组优良率为95.35%(41/43),明显高于对照组的80.95%(34/42),差异有显著性(P<0.05)。两组患者的并发症发生情况差异无显著性(P>0.05)。结论钛制弹性髓内钉治疗小儿尺桡骨不稳定骨折可有效减轻术后疼痛,改善肘关节功能,不良反应情况可控,值得临床应用。
Objective To explore the effect of titanium elastic intramedullary nail on the VAS score,adverse reactions and incidence of incision infection after the treatment of unstable ulna and radius fractures in children.Method A selection of 85 children with unstable double fractures of the ulna and radius treated in our hospital from February 2018 to December 2019 were divided into a control group(42 cases)and an observation group(43 cases)according to a random number table.The control group was treated with steel plate internal fixation and disinfection supply intervention,and the observation group was treated with intraoperative disinfection supply intervention of titanium elastic intramedullary nails for unstable fractures of the ulna and radius.The two groups of children were counted 1 day before treatment(in-hospital follow-up)and 3 months after treatment(re-visit)forearm pronation and forearm supination angles to evaluate the loss of wrist flexion and extension,pain visual analog scale(VAS)and Broberg-Morrey score.Result After 3 months of treatment,the observation group’s VAS score after treatment was significantly lower than that of the control group(P<0.05).There was no significant difference in the preoperative VAS scores between the two groups(P>0.05).The VAS score of the observation group was significantly lower than that of the control group at 1 day after operation,and the difference was significant(P<0.05).The Broberg-Morrey elbow joint function score showed that the excellent and good rate of the observation group was 95.24%(40/42)in the observation group after 3 months,which was significantly higher than that of the control group,80.95%(34/42),the difference was significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Titanium elastic intramedullary nails for the treatment of unstable fractures of the ulna and radius in children can effectively reduce postoperative pain and improve the function of the elbow joint.The adverse reactions are controllable and are worthy of clinical application.
作者
张春燕
Zhang Chunyan(Xiaoshan District Hospital of Traditional Chinese Medicine,Zhejiang Hangzhou 311200,China)
出处
《中国医刊》
CAS
2021年第3期271-273,共3页
Chinese Journal of Medicine
基金
2020年度浙江省中医药科技计划(2020ZB090)。
关键词
小儿尺桡骨不稳定双骨折
腕屈伸度
桡神经损伤
钛制弹性髓内钉
内固定
Unstable double fractures of ulna and radius in children
Wrist flexion and extension
Radial nerve injury
Titanium elastic intramedullary nail
Internal fixation