儿童盖氏骨折样损伤的诊断及治疗

Diagnosis and treatment of galeazzi fracture like injury in children

目的:探讨儿童盖氏骨折样损伤的诊断及治疗。方法:2008年7月-2014年6月收治儿童盖氏骨折患儿7例,均无明显下尺桡脱位征象,但尺侧存有肿胀压痛症状。患儿采取闭合复位保守治疗(4例)和微创经皮克氏针固定术(3例)。术后给予旋后位石膏长臂石膏固定。结果:所有骨折均愈合,无下尺桡关节脱位表现,2例患儿按照软组织损伤处理,复查时予以石膏旋后位,石膏制动症状改善。结论:治疗儿童盖氏骨折样损伤需要对该损伤有一个全面的认识,处理桡骨骨折同时注意到尺侧症状、损伤可能原因及相关处理,治疗方面对简单的桡骨骨折行手法复位,对于复位不理想的骨折可配合微创切口经皮克氏针进行骨折对位固定,并对尺侧进行适度的整复,避免肌腱的崁顿。

Objective:To investigate the diagnosis and treatment of galeazzi fracture like injury in children.Methods:7 cases of galeazzi fracture were selected from July 2008 to June 2014.There were no obvious signs of distal radioulnar dislocation,but there were symptoms of swelling and tenderness over the ulnar side.The children were given the closed reduction conservative treatment(4 cases) and minimally invasive percutaneous kirschner wire fixation(3 cases).And they were given the supination gypsum long arm cast immobilization after the operation.Results:All fractures were healed,and no dislocation of distal radioulnar joint performance.2 cases were given the treatment of soft tissue injury.They were given gypsum supination when review.The gypsum brake symptoms was improved.Conclusion:In the treatment of children's injury cover,we need to have a comprehensive understanding of the damage fracture.When we treated the fracture of radius,we also noticed the may cause injury of the ulnar side symptoms and related processing.In the treatment,we took manual reduction for simple fracture of radius.For the reset is not ideal fracture,we can combine with minimally invasive incision percutaneous K-wire fracture alignment fixed,and on the ulnar side of moderate reduction to avoid tendon Kan meal.