Huang Wei, Zhang Xu, Zhu Hongwei, Wang Xianhui, Sun Jianxin, Shao Xinzhong
Chengde Medical College, Chengde, Hebei 067000, China.
Hand Surgery Department, The Second Hospital of Qinhuangdao, Changli, Qinhuangdao, Hebei 066600, China.
Injury. 2016 Jun;47(6):1229-35. doi: 10.1016/j.injury.2016.02.011. Epub 2016 Feb 27.
The objective of this study is to introduce a novel percutaneous reduction technique for irreducible and difficult paediatric radius and ulna fractures in the distal forearm.
From May 2010 to January 2012, the percutaneous joystick technique was conducted in 48 children who sustained irreducible or difficult radius and ulna fractures in the distal forearm. The series comprises 32 male and 16 female patients with an average age of 11 years (range, 7-15 years). Among them, 22 patients were <9 years of age. At the final follow-up, the range of motion of the wrist and grip strength of the hand were assessed. Measurements were compared to those on the opposite side. Wrist function was assessed with Mayo Wrist Score. Appearance and patient satisfaction were assessed using the 10-cm visual analogue scale. A p-value <0.05 was considered statistically significant.
Bone healing was achieved in all patients (radius: mean 3.5 weeks, range, 3-4 weeks; ulna: 3.8 weeks, range, 3-4 weeks), respectively. After an average follow-up period of 39 months (range, 36-45 months), patients had an average range of wrist motion of 74° (range, 65-86°) in flexion and 64° (range, 54-78°) in extension. The mean grip strength of the injured side was 33.7kg (13.8-47.6kg). The mean Mayo Wrist Score was 97 (range, 85-100), including 44 excellent and four good results. The mean scores of appearance and patient satisfaction on the forearm were 9.7 (range, 9-10) and 9.8 (range, 8-10), respectively. No significant difference was found regarding the range of motion and grip strength (p<0.05).
The percutaneous reduction technique is a safe and valuable procedure for irreducible and difficult paediatric fractures of distal radius and ulna.
本研究的目的是介绍一种用于治疗小儿前臂远端不可复位及复杂桡骨和尺骨骨折的新型经皮复位技术。
2010年5月至2012年1月，对48例小儿前臂远端不可复位或复杂桡骨和尺骨骨折患儿采用经皮操纵杆技术。该组包括32例男性和16例女性患者，平均年龄11岁（范围7 - 15岁）。其中，22例患者年龄<9岁。在末次随访时，评估腕关节活动范围和手部握力。测量结果与对侧进行比较。采用梅奥腕关节评分评估腕关节功能。使用10厘米视觉模拟量表评估外观和患者满意度。p值<0.05被认为具有统计学意义。
所有患者均实现骨折愈合（桡骨：平均3.5周，范围3 - 4周；尺骨：3.8周，范围3 - 4周）。平均随访39个月（范围36 - 45个月）后，患者腕关节平均屈曲活动范围为74°（范围65 - 86°），伸展活动范围为64°（范围54 - 78°）。患侧平均握力为33.7kg（13.8 - 47.6kg）。平均梅奥腕关节评分为97分（范围85 - 100），其中44例为优，4例为良。前臂外观和患者满意度的平均评分分别为9.7分（范围9 - 10）和9.8分（范围8 - 10）。在活动范围和握力方面未发现显著差异（p<0.05）。
经皮复位技术是治疗小儿不可复位及复杂桡骨和尺骨远端骨折的一种安全且有价值的方法。
