弹性髓内针单根骨折固定治疗儿童前臂双骨折

Single bone intramedullary elastic nailing fixation for treatment of pediatric both bone fracture of the forearm

目的 探讨弹性髓内针单根骨折固定治疗儿童前臂双骨折的临床疗效.方法 自2008年1月至2012年12月,回顾性分析24例采用弹性髓内针单根骨折固定治疗儿童前臂双骨折的临床疗效.男15例,女9例;年龄6～13岁,平均9.6岁.对骨折移位较为明显的骨折进行内固定,其中桡骨固定16例,尺骨8例.术后长臂石膏托固定4周.术后通过X线片判断骨折愈合时间,采用Price标准评定前臂功能.结果 21例获得随访,3例失访,随访时间6～14个月,平均8.4个月.末次随访时按Price评分标准评定：优14例,良7例.术后2例出现髓内钉钉尾激惹症状,无伤口感染、血管神经损伤等并发症.结论 对部分前臂双骨折的儿童,采用弹性髓内针单根骨折固定是一种微创有效的治疗方法.

Objective To evaluate the clinical outcomes of treating pediatric forearm both bone fractures with single bone elastic intramedullary nailing （EIN） fixation.Methods A retrospective analysis was conducted of 24 cases of forearm both bone fractures treated with EIN fixation of single bone from January 2008 to December 2012.There were 15 boys and 9 girls with a median age of 9.6 years （range,6 to 13 years）.The bone with more obvious fracture displacement was fixed with the EIN.The radius was fixed in 16 cases while in the other 8 cases the ulna was fixed.All had a course of immobilization with long arm cast for 4 weeks.Fracture healing time was determined by X-rays.Forearm functions were evaluated using Price criteria.Results Twenty-one cases were follow-up for 8.4 months （range,6 to 14 months） postoperatively.Three cases were lost to follow-up.All fractures healed.According to the Price criteria,the results were rated as excellent in 14 cases and good in 7 cases.Skin irritation around the nail was found in 2 patients.There were no infections,nonunions,maltmions,or neurovascular injuries.Conclusion Single-bone intramedullary nailing fixation is a minimally invasive and effective treatment for pediatric forearm both bone fractures.