弹性髓内针治疗儿童桡骨颈骨折的方案选择

Selection of the treatment scheme of elastic stable intramedullary nail in treatment of radial neck fracture in children

目的分析弹性髓内针固定在不同类型儿童桡骨颈骨折的应用效果。方法选择2011年4月至2017年3月使用弹性髓内针治疗的儿童桡骨颈骨折54例,其中男38例,女16例;年龄4～14岁,平均年龄8岁4个月。根据Judet分度,Ⅱ度12例,Ⅲ度34例,Ⅳ度8例。均为单纯桡骨颈骨折,不合并其他部位骨折和血管、神经损伤。结果 54例均获6～18个月随访,平均随访时间9.2个月。术后采用Metaizeau评价标准对肘关节及前臂功能进行评价,54例中优良44例,中5例,差5例,优良率为81.5%。手术过程无血管、神经损伤发生,骨折均达到一期愈合,其中3例出现桡骨头骨骺缺血改变。结论弹性髓内针治疗儿童桡骨颈骨折是一种微创、操作简单、效果良好的治疗方法。

Objective To analyze the application effects of elastic stable intramedullary nail(ESIN) fixation in different types of radial neck fracture in children.Methods A total of 54 children with radial neck fracture who were treated by elastic stable intramedullary nail in our hospital from April 2011 to March 2017 were enrolled in the study,on whom, there were 38 males and 16 females,with age range: 4~14 yr and average age being 8 years and 4 months.According to Judet grading,there were 12 cases of gradeⅡ,34 cases of grade Ⅲ and 8 cases of grade Ⅳ. All the patients were pure radial neck fractures that were not combined with the other fractures and vascular and nerve injuries.Results The 54 patients were followed up for 6~18 months, with average follow-up time being 9.2 months. After surgery the function of elbow and forearm was evaluated by Metaizeau evaluation standard.Among the 54 patients, 44 cases were excellent and good, 5 cases were medium and 5 cases were poor,and the excellent and good rate was 81.5%. During the operation, no vascular or nerve injury occurred, and all fractures reached the first stage of healing, of whom, 3 cases had radius head epiphyseal ischemia.Conclusion The elastic intramedullary nail is a minimally invasive, simple and effective method in treatment of radial neck fracture in children.