超声引导弹性髓内钉治疗儿童尺桡骨双骨折

Ultrasound guided elastic intramedullary nail in the treatment of double fractures of ulna and radius in children

目的探讨应用超声引导弹性髓内钉治疗儿童尺桡骨双骨折的临床疗效。方法自2015年1月至2019年4月我科采用超声引导弹性髓内钉治疗儿童尺桡骨双骨折25例,男14例,女11例;年龄6~12岁,平均9.1岁。从切口长度、手术时间、术中出血量、术中C臂机透视次数、骨折愈合时间、腕关节和肘关节活动度等指标分析其临床疗效。结果术后25例均获得随访,时间为12~18个月,平均15.6个月。切口长度平均(2.8±0.5)cm,手术时间平均(42.5±3.8)min,术中出血量平均(5.2±1.3)ml,术中C臂机透视次数平均(3.5±0.7)次;骨折愈合时间平均(5.1±1.2)周;末次随访时Cooney腕关节和Mayo肘关节功能评分为97.2±2.1和97.8±1.1,无骨折不愈合及畸形愈合、神经血管损伤、骨骺早闭,无针尾激惹症状。结论超声引导弹性髓内钉治疗儿童尺桡骨双骨折具有微创、出血少、术中C臂机透视次数少、疗效确切的特点,并且二次取出方便,可减轻患儿痛苦。

Objective To investigate the clinical efficacy of ultrasound guided elastic intramedullary nail in the treatment of double fractures of ulna and radius in children.Methods From January 2015 to April 2019,25 cases of double fractures of ulna and radius in children treated by ultrasound guided elastic intramedullary nail were retrospectively analyzed.The clinical efficacy was analyzed from the indexes of incision length,operation time,intraoperative bleeding,intraoperative C-arm fluoroscopy times,fracture healing time,wrist and elbow mobility and so on.Results All the cases were follow-up for 12 to 18 months,with an average of 15.6 months.The incision length was(2.8±0.5)cm.The operation time was(42.5±3.8)minutes.The intraoperative bleeding volume was(5.2±1.3)ml.The times of C-arm fluoroscopy were 3.5±0.7.The fracture healing time was(5.1±1.2)weeks.At the last follow-up,Cooney wrist and Mayo Elbow function scores were(97.2±2.1)points and(97.8±1.1)points respectively.No fracture nonunion and malunion,neurovascular injury,early epiphyseal closure,needle tail irritation symptoms occurred.Conclusion The ultrasound guided elastic intramedullary nail in the treatment of double fractures of ulna and radius in children has the characteristics of minimally invasive,less bleeding,less times of intraoperative C-arm fluoroscopy,accurate curative effect,and it is convenient for secondary removal,so as to reduce the pain of children.