多功能外固定支架在小儿干骺端骨折中的应用

Dynamic trans-articular external fixation device for treating metaphyseal fractures in children

目的：探讨手法复位结合外固定支架治疗小儿干骺端骨折的效果。方法2008年1月-2013年使用单边多功能骨科外固定支架治疗小儿干骺端骨折48例，闭合复位44例，有限切开复位4例，外固定采用单边多功能骨科外固定支架。开放性骨折6例，伤口均Ⅰ期缝合。结果48例均获随访，时间6个月~14个月，骨折临床愈合时间6周~8周。疗效评定采用Joher-Wruh评分标准：优41例，良5例，可2例，治愈率100％，无骨折延期愈合、不愈合及畸形愈合，无术后严重钉道感染及钢针折断弯曲。结论手法复位外固定架治疗小儿干骺端骨折能使骨折复位、固定满意，避免骨骺损伤，利于术后早期功能锻炼，是治疗小儿干骺端骨折的有效方法。

Objective To explore the results of manipulative reduction and trans-articular fixation with unilateral external fixators in the treatment and to improve the therapeutic levels of metaphyseal fractures in children.Methods From 2008 to 2013, unilateral external fixators were used in the treatment of metaphyseal fractures in children. 44 cases were treated with manipulative reduction, 4 cases were treated with open reduction, 6 cases were compound fracture, all cases were primary wound healing. Results Follow-ups lasted from 6 to 14 months . The time of bone healing was 6 to 8 weeks, the therapeutic effect results included 41 excellent cases, 5 good and 2 fair according to the Joher Wruh system. The cure rate was 100%.There was no nonunion and malunion.There was no severe postoperative infections and Curved needle break. Conclusion Manipulative reduction and trans-articular fixation with unilateral external fixators, which is advantageous to fracture reduction, solid fixation, avoiding epiphyseal injury and early postoperative mobilization , is an effective method to treat metaphyseal fractures in children.