Chen Guo-Fu, Liang Jun-Bo, Zhang Chuan-Yi, Wang Bin, Cai Guo-Ping, Yao Can
Department of Orthopaedics, Taizhou Hospital, Linhai 317000, Zhejiang, China.
Zhongguo Gu Shang. 2022 Aug 25;35(8):752-6. doi: 10.12200/j.issn.1003-0034.2022.08.010.
To explore the clinical effect of Kirschner wire retractor-assisted reduction and inverted insertion of elastic nail in the treatment of children's irreducible subradial 1/3 fractures.
A total of 34 children with irreducible subradial 1/3 fractures treated by surgery from August 2016 to December 2020 were retrospective analyzed. Among them, 16 cases underwent Kirschner wire retractor-assisted closed reduction and percutaneous elastic intramedullary nailing with inverted insertion(observation group), 10 males and 6 females, aged from 4 to 10 years old with an average of(6.0±0.4)years;18 cases underwent open reduction and plate internal fixation (control group), 11 males and 7 females, the age from 3 to 10 years with an average of(7.0±0.5) years. The operation time, intraoperative blood loss, hospital stay, incision length, fracture healing time and complications of the two groups were observed and the wrist function was evaluated by Cooney wrist joint score.
All patients were followed up for 3-12 years old with an average of (11.40±0.48) months in the observation group and 4-13 months with an average of (11.50±0.39) months in the control group. Bone healing was achieved in all patients, and there was no incision infection in both groups. The operation time, intraoperative blood loss, hospital stay and incision length in observation groups were lower than those of control group (<0.05). There was no significant difference in the fracture healing time between two groups(>0.05). There was no significant difference in postoperative healing and recovery of wrist function between groups(>0.05).
Compared with open reduction and plate internal fixation, Kirschner wire retractor-assisted reduction and percutaneous elastic intramedullary nail fixation for irreducible subradial radial 1/3 fractures has the advantages of less trauma, shorter operation time, less blood loss, and satisfactory short-term clinical results.
探讨克氏针牵开器辅助复位及弹性髓内钉倒打置入治疗儿童桡骨远端1/3难复性骨折的临床疗效。
回顾性分析2016年8月至2020年12月手术治疗的34例儿童桡骨远端1/3难复性骨折患者。其中，16例行克氏针牵开器辅助闭合复位经皮弹性髓内钉倒打置入术（观察组），男10例，女6例，年龄4～10岁，平均（6.0±0.4）岁；18例行切开复位钢板内固定术（对照组），男11例，女7例，年龄3～10岁，平均（7.0±0.5）岁。观察两组手术时间、术中出血量、住院时间、切口长度、骨折愈合时间及并发症情况，并采用Cooney腕关节评分评估腕关节功能。
观察组所有患者随访3～12个月，平均（11.40±0.48）个月；对照组随访4～13个月，平均（11.50±0.39）个月。所有患者均骨折愈合，两组均无切口感染。观察组手术时间、术中出血量、住院时间及切口长度均低于对照组（P<0.05）。两组骨折愈合时间差异无统计学意义（P>0.05）。两组术后腕关节功能恢复情况差异无统计学意义（P>0.05）。
与切开复位钢板内固定相比，克氏针牵开器辅助复位经皮弹性髓内钉固定治疗儿童桡骨远端1/3难复性骨折具有创伤小、手术时间短、出血少、短期临床效果满意等优点。
