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经皮克氏针撬拨复位联合杠杆固定治疗儿童桡骨颈骨折

Percutaneous reduction and leverage fixation using K-wires in paediatric angulated radial neck fractures.

机构信息

Orthopaedics, Chungnam National University Hospital, Daejeon, South Korea.

出版信息

Int Orthop. 2012 Apr;36(4):803-9. doi: 10.1007/s00264-011-1387-3. Epub 2011 Oct 29.

Abstract

PURPOSE

We evaluated the usefulness of percutaneous reduction and leverage fixation using K-wires in children with radial neck fractures.

MATERIALS AND METHODS

Between 2006 and 2008, we evaluated 13 paediatric patients with radial neck fractures who had been observed for at least two years and underwent percutaneous reduction and leverage fixation using K-wires. We measured radial angulation and radial translation using preoperative, postoperative and final follow-up radiographs, and we clinically investigated range of motion and carrying angle according to Steele's grading system.

RESULTS

Excellent clinical results were achieved in 11 (84.6%) patients, good results in one (7.6%) and fair results in one (7.6%). There were no poor results. The patient in whom fair results were achieved also had an olecranon fracture, which was treated conservatively. Complications such as nonunion, infection, iatrogenic nerve injury and periarticular ossification were minimal. Radioulnar synostosis was absent between the radial neck fracture and the greenstick fracture of the olecranon. Growth arrest in the proximal radial epiphysis was also absent.

CONCLUSION

Percutaneous reduction and leverage fixation using K-wires in children with radial neck fractures is a recommended surgical treatment that can achieve recovery of normal radial angulation and elbow motion.

摘要

目的

我们评估了在儿童桡骨颈骨折中使用克氏针经皮复位和杠杆固定的效果。

材料和方法

2006 年至 2008 年,我们评估了 13 例接受过克氏针经皮复位和杠杆固定的儿童桡骨颈骨折患者,这些患者至少接受了两年的观察。我们使用术前、术后和最终随访的 X 线片测量桡骨角度和桡骨位移,并根据 Steele 分级系统进行临床研究,包括活动范围和携带角。

结果

11 例(84.6%)患者获得了良好的临床效果,1 例(7.6%)为良好,1 例(7.6%)为一般。没有差的结果。获得一般结果的患者还伴有尺骨鹰嘴骨折,采用保守治疗。并发症如骨不连、感染、医源性神经损伤和关节周围骨化等很少见。桡骨颈骨折和尺骨鹰嘴青枝骨折之间没有桡尺骨融合。桡骨近端骨骺生长停滞也不存在。

结论

在儿童桡骨颈骨折中使用克氏针经皮复位和杠杆固定是一种推荐的手术治疗方法,可以恢复正常的桡骨角度和肘部运动。

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