改良Metaizeau法治疗Judet Ⅲ型或Ⅳ型儿童桡骨颈骨折

Modified Metaizeau's technique for the treatment of radial neck fractures of Judet Ⅲ or Ⅳ in children

目的 :探讨改良Metaizeau法治疗JudetⅢ或Ⅳ型儿童桡骨颈骨折的临床疗效。方法:自2014年5月至2017年3月收治JudetⅢ或Ⅳ型儿童桡骨颈骨折患者32例,男21例,女11例;年龄5.7~10.6岁,平均7.2岁。32例患者均在经皮克氏针撬拨复位辅助下,行弹性髓内针固定。采用改良An-Morrey肘关节功能评分评价肘关节活动度、力量、稳定性、疼痛。结果:所有病例获得术后随访,时间12~15个月。术后患儿均未出现切口感染、钉尾刺激、桡骨小头坏死等并发症。术后8~10周骨折获得骨性愈合。改良An-Morrey肘关节功能评分由术前的58.69±5.80提高到术后12个月的99.13±1.79,差异有统计学意义(P<0.05)。结论 :改良Metaizeau法治疗儿童桡骨颈骨折,手术并发症少,创伤小,骨折愈合率高,有利于肘关节功能的恢复。

Objective：To explore the clinical effect of modified Metaizeau＇ s technique for radial neck fractures of Judet Ⅲ or IV in children, summarizing the value of clinical application. Methods：From May 2014 to March 2017,32 children of Judet Ⅲ or IV radial neck fractures were treated with percutaneous Kirschner wire poking reduction and closed reduction with elastic intramedullaly nailing fixation, including 21 boys and 11 girls, aged from 5.7 to 10.6 years old with a mean of 7.2 years old. The modified An-MolTey functional rating index were used to evaluate elbow range of motion, myodynamia, stability, and pain preoperatively and 1 year postoperatively in all the patients. Results：All patients were available for an average follow-up from 12 to 15 months. No complications such as incision hffection,wire or nail tail irritation and avascular necrosis of radial head and epiphyses was occmTed. The fracture achieved solid healing at 8 to 10 weeks after operation. The modified An and Morrey functional score improved from 58.69±5.80 before operation to 99.13±1.79 at 1 year after operation,there was obvious difference of scores between preoperative and postoperative at 1 year. Conclusion： Modified Metaizeau＇ s technique is a reliable and good treatment for Judet Ⅲ or Ⅳ radial neck fractures in children, which has advantages of few complication, minimal invasion, quick fracture union and good recovery of elbow joint.