早期康复训练联合闭合复位经皮空心钉内固定对儿童内踝Salter-HarrisHI型骨骺骨折的康复效果分析

Effect of Early Rehabilitation Training Combined with Closed Reduction and Percutaneous Hol- low Nail Fixation on Salter-Harris m Epiphyseal Fracture of Medial Malleolus in Children

【目的】探讨早期康复训练联合行闭合复住经皮空心钉内固定对儿童内踝Salter-HarrisⅢ型骨骺骨折的康复效果。【方法】选择2014年1月至2016年1月在本院就诊的36例内踝SalterHarrisHI型骨骺骨折的患儿，随机分为观察组和对照组各18例。对照组行闭合复住经皮空心钉内固定加，在骨折线模糊后开始功能锻炼，观察组术后进行早期康复训练，比较两组的ASOFAS康复评分、患者满意率。【结果】观察组术后4个月、术后8个月、术后12个月的优良率分别为66．67％，77．78％和83．33％均显著高于对照组的55．56％，61．11％，77．78％，差异具有统计学意义（Pd0．05）；观察组满意率88．89％，显著高于对照组的66．67％，差异有统计学意义（P〈0．05）。【结论】早期康复训练联合闭合复位经皮空心钉内固定治疗儿童内踝Salter-Har—risⅢ型骨骺骨折，有助于提高患儿康复效果，加快患儿关节功能恢复。

[Objective]To investigate the effect of early rehabilitation training combined with closed reduc- tion and percutaneous hollow nail fixation on Salter-Harris Ⅲ epiphyseal fracture of medial ma[leolus in chil- dren. [Methods]From January 2014 to January 2016, 36 children with Salter-Harris type Ⅲ epiphyseal frac- ture of medial malleolus were randomly divided into two groups： study group （ n =18） and control group （ n = 18）. The control group was treated with closed reduction and internal fixation with percutaneous hollow nail and functional exercise began after the fracture line was blurred. The study group received early rehabilitation training after operation and the ASOFAS rehabilitation scores, the rate of satisfaction and the occurrence of complications of the two groups were compared.[Results]The excellent and good rates of the observation group were 66.67 % and 83.33 % at 4 months, 8 months and 12 months, respectively, which were significantly higher than that of the control group （55.56 % ）. The difference was statistically significant （ P 〈0.05）. The satisfaction rate of the observation group was 88.89%, which was significantly higher than that of the control group （66.67%）. The difference was statistically significant （ P 〈0.05）. In the control group, there were 2 cases of incision infection, 1 ease of malleolus varus malformation and I case of delayed fracture healing. In the study group, the fracture of internal fixation occurred in 1 case （ P （0.05）.[Conclusion]Early rehabilitation training combined with closed reduction and internal fixation with percutaneous hollow nail for the treatment of Salter-Harris Ⅲ epiphyseal fractures of the medial malleolus in children is helpful to improve the rehabilitation effect of children and accelerate the recovery of joint function in children. Effective reduction of complications, children are more satisfied with the treatment.