Parajuli N P, Shrestha D, Dhoju D, Dhakal G R, Shrestha R, Sharma V
Department of Orthopaedics and Traumatology, Dhulikhel Hospital- Kathmandu University Hospital, Nepal.
Kathmandu Univ Med J (KUMJ). 2011 Jul-Sep;9(35):198-202. doi: 10.3126/kumj.v9i3.6305.
Though most of the pediatric diaphyseal forearm bone fracture can be treated with closed reduction and cast application, indications for operative intervention in pediatric both-bone forearm fractures include open fractures, irreducible fractures, and unstable fractures. Controversy exists as to what amount of angulation, displacement, and rotation constitutes an acceptable reduction.
To review union time and functional outcome of pediatric diaphyseal forearm bone fracture managed with intramedullary rush pin by closed or open reduction.
Fifty patients with both bone fracture of forearm were treated with intramedullary rush pin by closed or open reduction were included in the study and followed up for minimum six months for radiological and functional outcome.
Out of 50 patients, 31 underwent closed reduction and 19 underwent open reduction. All fractures maintained good alignment post operatively. Forty seven patients had excellent results with normal elbow range of motion and normal forearm rotation and three patients had good results. In all patients good radiological union was seen in three months time. Eight patients had minor complications including skin irritation over prominent hardware, backing out of ulnar pin, superficial skin break down with exposed hardware. Twenty-three (46%) patients had undergone implant removal at an average of 6 months (range 4-8 months) under regional or general anesthesia.
Fixation with intramedullary rush pin for forearm fracture is an effective, simple, cheap, and convenient way for treatment in pediatric age group.
尽管大多数小儿前臂骨干骨折可通过闭合复位和石膏固定进行治疗,但小儿双骨折前臂骨折手术干预的指征包括开放性骨折、不可复位骨折和不稳定骨折。对于多大程度的成角、移位和旋转构成可接受的复位存在争议。
回顾采用髓内 Rush 针通过闭合或开放复位治疗小儿前臂骨干骨折的愈合时间和功能结果。
本研究纳入 50 例采用髓内 Rush 针通过闭合或开放复位治疗的双前臂骨折患者,并对其进行至少 6 个月的随访,以观察影像学和功能结果。
50 例患者中,31 例行闭合复位,19 例行开放复位。所有骨折术后均保持良好对线。47 例患者结果优异,肘关节活动范围正常,前臂旋转正常,3 例患者结果良好。所有患者在 3 个月时均见良好的影像学愈合。8 例患者出现轻微并发症,包括突出内固定物处皮肤刺激、尺骨针退出、浅表皮肤破损伴内固定物外露。23 例(46%)患者在区域或全身麻醉下平均 6 个月(范围 4 - 8 个月)取出内固定物。
采用髓内 Rush 针固定治疗小儿前臂骨折是一种有效、简单、廉价且方便的治疗方法。