钛制弹性髓内钉治疗儿童不稳定尺桡骨干双骨折的临床研究

Clinical study of titanium elastic intramedullary nail in the treatment of unstable double fractures of ulna and radius in children

目的:探讨钛制弹性髓内钉闭合复位治疗儿童不稳定尺桡骨干双骨折的临床疗效。方法:纳入2016年6月―2020年5月甘肃中医药大学附属医院收治的儿童不稳定尺桡骨干双骨折63例,随机分为两组,观察组32例,采用闭合复位下钛制弹性髓内钉固定;对照组31例,采用切开复位钢板内固定。两组均记录手术时间、住院时间、骨折愈合时间、术中出血量、前臂Grace and Eversman功能分级和疼痛视觉模拟评分法(Visual Analogue Scale,VAS)评分。结果:63例患者均顺利完成手术,其中观察组的手术时间、住院时间、骨折愈合时间和术中出血量均明显少于对照组,差异有统计学意义(P<0.05)。两组间疼痛VAS评分的差异有统计学意义(P<0.05)。两组的前臂Grace and Enversman功能的差异无统计学意义(P>0.05),但观察组患者前臂Grace-Enversman功能恢复更好。结论:钛制弹性髓内钉内固定治疗儿童不稳定尺桡骨干双尺骨折可有效缩短手术时间及住院时间,降低出血量,并降低患儿术后的疼痛,明确改善前臂功能,值得临床应用。

Objective:To explore the clinical effect of closed reduction with double titanium elastic intramedullary nails in the treatment of unstable double fractures of the ulna and radius in children.Methods:A total of 63 children with unstable fractures of the ulna and radius fractures treated in Affiliated Hospital of Gansu University of Traditional Chinese Medicine from June 2016 to May 2020 were randomly divided into two groups:the observation group(32 cases),received titanium elastic intramedullary nail fixation under closed reduction,and the control group,accept open reduction plate internal fixation treatment.The operation time,hospital stay,fracture healing time,intraoperative bleeding,forearm Grace and Eversman functional score and pain VAS score were recorded in both groups.Results:The operation time,hospital stay,fracture healing time and intraoperative bleeding amount in the observation group were significantly less than those in the control group(P<0.05).There was significant difference in VAS scores between the two groups(P<0.05).There was no significant difference in Grace and Enversman function between two groups(P>0.05),but the recovery of Grace and Enversman function was better in the observation group than that in the control group.Conclusion:Titanium elastic intramedullary nail internal fixation can effectively shorten the operation time and hospital stay,reduce the amount of bleeding,reduce postoperative pain,and improve forearm function in the treatment of children with unstable fractures of ulna and radius,it is worthy of clinical application.