骑缝钉治疗儿童肱骨近端干骺端骨折的疗效评价

Analysis of the efficacy of straddle nails in the treatment of proximal humeral metaphyseal fractures in children

目的观察骑缝钉治疗儿童肱骨近端干骺端骨折的临床疗效。方法选择皮山县人民医院、宣城市人民医院2017年8月至2019年8月收治且获得完整随访的26例儿童肱骨近端干骺端骨折患儿为研究对象,回顾性分析手术时间、术中出血量、骨折愈合时间、术后1周肩关节Neer评分、术后内固定并发症。结果 26例患儿均采用切开复位骑缝钉内固定,手术时间为30~45 min,平均(39.5±4.3) min;术中出血量20~35 mL平均(28.7±4.2) mL;骨折愈合时间10~15周,平均(12.6±2.1)周;术后1周肩关节Neer评分为88~97分,平均(93.6±2.7)分;切口均一期愈合,无骨折畸形愈合,无内固定松动或断裂并发症发生。结论骑缝钉是治疗儿童肱骨近端干骺端骨折的有效术式,手术操作简捷,出血少,对干骺端损伤小,固定可靠,骨折愈合快,有利于患儿早期功能锻炼。

Objective To observe the clinical effect of straddle nails internal fixation in the treatment of proximal humeral metaphyseal fractures in children. Methods The data of 26 children with proximal humeral metaphyseal fractures from Pishan County People’s Hospital and People’s Hospital of Xuancheng City who were followed up from August 2017 to August 2019 were selected as the research objects.The operation time, intraoperative blood loss, fracture healing time, Neer score of shoulder joint 1 week after surgery and postoperative internal fixation complications were analyzed retrospectively. Results All of the 26 patients were treated open reduction and straddle nail internal fixation, The operation time was 30~45 minutes, with an average of(39.5±4.3) minutes. The intraoperative bleeding was 20~35 mL, with an average of(28.7±4.2) mL. The fracture healing time was 10~15 weeks, with an average of(12.6±2.1) weeks. 1 week after surgery, the Neer score of shoulder joint was 88~97(93.6±2.7), and the operation was healed in one stage, no malunion of fracture, and there was no complication of loosening or fracture of internal fixation. Conclusion The straddle nail internal fixation is an effective method for the treatment of proximal humeral metaphyseal fractures in children. It has the advantages of simple operation, less bleeding, less injury to the epiphysis, reliable fixation and rapid fracture healing, which is beneficial to early functional exercise of children.