Chen Xiaoliang,Zhou Zhiguo,Wu Xing,et al. Intraoperative application of ultrasound for supracondylar femoral fracture in children.[J].Journal of Clinical Pediatric Surgery,2019,18(01):30-33.
超声技术在儿童股骨髁上骨折闭合复位内固定手术中的应用价值
- Title:
- Intraoperative application of ultrasound for supracondylar femoral fracture in children.
- Keywords:
- ; Ultrasonography; Femoral Supracondylar Fracture; Surgical Procedures; Operative; Internal Fixators; Child
- 文献标志码:
- A
- 摘要:
- 目的探讨超声技术在儿童股骨髁上骨折闭合复位内固定术中的应用价值。方法回顾性分析2012年1月至2016年6月华中科技大学同济医学院附属武汉儿童医院收治的12例具备手术指征的股骨髁上骨折患儿的临床资料，其中男8例，女4例。年龄8个月至12岁（平均5岁7个月），均采用超声引导下闭合复位克氏针内固定联合石膏外固定治疗，记录手术时间、术后出院时间、并发症及骨折愈合的时间，并于术后6个月、1年及2年分别测量双下肢长度、下肢机械力线及股骨远端骨骺发育情况。末次随访采用 Kolment 评定标准评价患儿膝关节的优良率。结果12例中无一例发生神经血管损伤、骨折端移位、膝内外翻畸形、克氏针松动、骨髓炎及骨化性肌炎等并发症。骨折骨性愈合时间为8~12周，平均(9.7±1.5)周，无不愈合或延迟愈合的情况。患儿均获1年以上随访，骨折全部愈合，膝关节功能完全恢复，步态正常，双下肢等长，无旋转畸形。 术后末次随访膝关节功能优良率为100%。结论超声引导下骨折闭合复位克氏针内固定石膏外固定术治疗效果基本满意。术中通过超声指导儿童的股骨髁上骨折闭合复位及克氏针穿针固定可达到治疗精确定位的目的。
- Abstract:
- ObjectiveTo explore the clinical value of ultrasonic technique in closed reduction plus internal fixation for supracondylar femoral fracture in children.MethodsRetrospective analysis was conducted for 12 children with supracondylar femoral fracture from January 2012 to June 2016.There were 8 boys and 4 girls with an average age of 67(8-144) months.Closed reduction,Kirschners wire internal fixation and plaster external fixation were performed under ultrasonic guidance.Operative duration,postoperative discharge time,complications and fracture healing time were recorded.Length of lower extremities,mechanical force lines of lower extremities and epiphyseal development of distal femur were measured at 6,12 and 24 months postoperation.And the Kolments criteria were employed for evaluating knee joint function at the last followup.ResultsDuring a followup period of over 1 year,there were no occurrences of such complications as neurovascular injury,displacement of fracture,Knee varus deformity,Kirschners wire loosening,osteomyelitis or ossifying myositis.The average time of fracture healing was (9.7±1.5)(8-12) weeks.All cases healed with a complete recovery of knee joint function.Gait returned to normal.All lower extremities were of an equal length and there was no rotation deformity.Based upon the Kolments criteria.The excellent and good rate was 100%.ConclusionUltrasound is safe,economical and reliable for guiding closed reduction and Kirschners wire fixation for supracondylar femoral fracture in children.
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