Yung S H, Lam C Y, Choi K Y, Ng K W, Maffulli N, Cheng J C
Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
J Bone Joint Surg Br. 1998 Jan;80(1):91-4. doi: 10.1302/0301-620x.80b1.8110.
Displaced fractures of the forearm in children are often treated conservatively, but there is a relatively high incidence of redisplacement, malunion and consequent limitation of function. We have performed percutaneous Kirschner (K) wire fixation in 72 such children under the age of 14 years, of which 57 were reviewed for our study. Both the radius and ulna were fractured in 45 (79%), the radius only in eight and the ulna only in four. The mean initial angulation was 19 degrees in the lateral plane and 9 degrees in the anteroposterior plane for the radius and 15 degrees and 9 degrees, respectively, for the ulna. In 42 patients (74%) we performed closed reduction. In the remaining 15 (26%) closed reduction failed and an open reduction, through a minimal approach, was required before K wiring. At a mean follow-up of 20 months all patients had good functional results with an excellent range of movement. Only five had angulation of from 10 degrees to 15 degrees and none had nonunion, premature epiphyseal closure or deep infection. Percutaneous intramedullary K wiring for forearm diaphyseal fracture is a convenient, effective and safe operation, with minimal complications.
儿童前臂移位骨折通常采用保守治疗，但再移位、畸形愈合及由此导致的功能受限发生率相对较高。我们对72例14岁以下此类儿童进行了经皮克氏针固定，其中57例纳入本研究进行随访。桡骨和尺骨双骨折45例（79%），单纯桡骨骨折8例，单纯尺骨骨折4例。桡骨初始平均成角在侧位平面为19度，前后位平面为9度；尺骨分别为15度和9度。42例患者（74%）进行了闭合复位。其余15例（26%）闭合复位失败，在克氏针固定前需通过微创入路进行切开复位。平均随访20个月时，所有患者功能恢复良好，活动范围极佳。仅5例有10度至15度的成角，无骨不连、骨骺过早闭合或深部感染发生。经皮髓内克氏针固定治疗前臂骨干骨折是一种简便、有效且安全的手术，并发症极少。
