单人折顶法复位治疗儿童尺桡骨远端骨折

Treatment of distal ulna and radius fractures in children by single-person fold-top manipulation

目的探讨单人折顶法复位治疗儿童尺桡骨远端骨折的临床效果,并介绍单人折顶整复手法及小夹板外固定使用方法。方法选择尺桡骨远端闭合性双骨折患儿18例,均采用单人折顶法整复、小夹板外固定治疗,观察骨折愈合情况,前臂的旋转及腕屈伸功能恢复情况。结果18例患儿术后复查X线片示:骨折解剖复位者10例,近解剖复位者8例。近解剖复位者骨折无旋转错位,无短缩错位,无尺桡骨骨骺损伤,骨折轻度掌侧成角≤10°,骨折对位达3/4以上。所有患儿均获随访,随访时间为3〜6个月,骨折均正常愈合,X线示骨折临床愈合时间为4〜6周。后期患肢前臂及腕关节功能均良好,无后遗症及并发症发生。结论折顶手法整复及小夹板外固定治疗儿童尺桡骨远端骨折效果良好,与手术治疗相比,费用低,痛苦小,无手术瘢痕,手法容易掌握,具有良好的临床疗效,避免二次手术,值得临床推广应用。

Objective To investigate the clinical effect of single-person fold-top manipulation for children distal ulnar and radius fractures,and introduce the technique of single-person fold-top manipulation and small splint external fixation.Methods 18 children with closed double fractures of distal radius and ulna were selected,all patients were treated with single-person fold-top manipulation and small splint external fixation.The fracture healing,forearm rotation and wrist flexion and extension function recovery were observed.Results The X-ray films of 18 cases showed that 10 cases were anatomically reduced and 8 cases were near anatomically reduced.No rotation dislocation,no shortening dislocation,no ulnar and radial epiphysis injury were found in the patients with near anatomical reduction.The angle of the volar side of the fracture was≤10°and the alignment of the fracture was more than 3/4.All children were followed up for 3-6 months.The fractures healed normally,and X-ray showed that the fracture healing time was 4-6 weeks.The function of forearm and wrist joint of the affected limb was good in the later stage,without sequelae and complications.Conclusion Compared with surgical treatment,single-person fold-top manipulation and small splint external fixation show good clinical effect for children with distal ulnar and radius fractures,which has the advantages of low cost,less pain,no surgical scar,easy manipulation,and can avoid the secondary operation.it is worthy of clinical promotion and application.