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儿童桡骨颈移位骨折:梅塔佐和博勒尔手术技术的关联

Displaced radial neck fractures in children: association of the Métaizeau and Böhler surgical techniques.

作者信息

Brandão Gilberto Francisco, Soares Cláudio Beling, Teixeira Luiz Eduardo Moreira, Boechat Lucas de Castro

机构信息

Brazilian Society of Orthopedics and Traumatology, Minas Gerais, Brazil.

出版信息

J Pediatr Orthop. 2010 Mar;30(2):110-4. doi: 10.1097/BPO.0b013e3181cf118a.

Abstract

OBJECTIVES

To evaluate the results of surgical treatment of displaced radial neck fractures in children using an association of the Böhler reduction technique and the intramedullary fixation described by Métaizeau.

METHODS

Of the 68 children diagnosed with radial neck fractures, 28 (41.1%) were classified as O'Brien type III and surgically treated by the association of Böhler and Métaizeau techniques between December 1998 and April 2007. Two patients were excluded for loss to follow-up, with a total of 26 patients (38.2%) remaining in the study group. The mean follow-up period was 52+/-3.2 months (range, 1.7 to 10 y).

RESULTS

Consolidation was achieved in all the fractures after 5 weeks postoperatively. None of the patients presented perioperative complications or infections. Only 1 child developed pain and loss of motion, requiring surgical revision. According to Tibone and Stoltz classification, 17 children (65.3%) healed with excellent results, 6 children(23%) with good results, 2 children (7.6%) with fair results, and 1 (3.8%) with poor results.

CONCLUSIONS

This association of techniques presents an excellent option for O'Brien type III fractures of the radial neck. It is easily executed, does not require elbow arthrotomy, and shows few complications.

LEVEL OF EVIDENCE

This is a therapeutic study level IV (case series).

摘要

目的

采用博勒尔复位技术与梅泰佐描述的髓内固定相结合的方法,评估儿童移位性桡骨颈骨折的手术治疗效果。

方法

在68例诊断为桡骨颈骨折的儿童中,28例(41.1%)被归类为奥布赖恩III型,并于1998年12月至2007年4月期间采用博勒尔和梅泰佐技术联合进行手术治疗。2例患者因失访被排除,研究组共26例患者(38.2%)。平均随访期为52±3.2个月(范围1.7至10年)。

结果

术后5周所有骨折均实现愈合。所有患者均未出现围手术期并发症或感染。仅1例儿童出现疼痛和活动受限,需要进行手术翻修。根据蒂博内和斯托尔茨分类,17例儿童(65.3%)愈合效果极佳,6例儿童(23%)愈合效果良好,2例儿童(7.6%)愈合效果尚可,1例(3.8%)愈合效果差。

结论

这种技术联合为奥布赖恩III型桡骨颈骨折提供了一种极佳的选择。操作简便,无需肘关节切开术,且并发症少。

证据水平

这是一项IV级治疗性研究(病例系列)。

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