儿童桡骨颈骨折撬拨复位后经皮克氏针与弹性髓内钉内固定的效果比较

Comparison on the Effects of Internal Fixation with Percutaneous Kirschner Wire and Flexible Intramedullary Nail After Reduction by Leverage in Children with Radial Neck Fracture

目的 对比撬拨复位后经皮克氏针与弹性髓内钉内固定治疗儿童桡骨颈骨折的临床效果。方法 130例行撬拨复位内固定的桡骨颈骨折患儿根据内固定方式的不同分为克氏针组和弹性髓内钉组,比较两组的围术期指标、并发症以及肘关节功能。结果 克氏针组的手术时间、术中失血量、住院时间均显著低于弹性髓内钉组(P <0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。术后1个月、 3个月,克氏针组的MEPS评分均显著高于弹性髓内钉组(P <0.05);术后6个月,两组的MEPS评分比较,差异无统计学意义(P>0.05)。结论 撬拨复位后经皮克氏针与弹性髓内钉内固定治疗桡骨颈骨折患儿均有良好的应用效果,但经皮克氏针可减轻手术创伤,有利于患儿肘关节功能的早期恢复。

Objective To compare the clinical effects of internal fixation with percutaneous Kirschner wire and flexible intramedullary nail after reduction by leverage in the treatment of children with radial neck fracture.Methods 130 children with radial neck fracture who underwent reduction by leverage and internal fixation were divided into the Kirschner wire group and the flexible intramedullary nail group according to different internal fixation methods.The perioperative indicators,complications and elbow joint function were compared between the two groups.Results The operation time,intraoperative blood loss amount and hospitalization time of the Kirschner wire group were significantly lower than those of the flexible intramedullary nail group(P <0.05).No significant difference was found in the incidence of complications between the two groups(P >0.05).At 1 month and 3 months after surgery,the MEPS scores of the Kirschner wire group were significantly higher than those of the flexible intramedullary nail group(P <0.05);No significant difference was found in the MEPS score at 6months after surgery between the two groups(P >0.05).Conclusions Both percutaneous Kirschner wire and flexible intramedullary nail internal fixation after reduction by leverage in the treatment of children with radial neck fracture have good application effect,but percutaneous Kirschner wire can reduce surgical trauma and is conducive to the early recovery of elbow joint function of children.