[1]张瑾,9,蒋飞,等.儿童陈旧孟氏骨折愈后的影响因素以及肘关节Kim评分及Mayo评分比较分析[J].临床小儿外科杂志,2019,18(11):916-921.[doi:10.3969/j.issn.1671—6353.2019.11.005]
　Zhang Jin,9,Jiang Fei,et al.Risk factors of pediatric neglected Monteggia fracture and Kim or Mayo Elbow performance score[J].Journal of Clinical Pediatric Surgery,2019,18(11):916-921.[doi:10.3969/j.issn.1671—6353.2019.11.005]
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儿童陈旧孟氏骨折愈后的影响因素以及肘关节Kim评分及Mayo评分比较分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第18卷 期数: 2019年11期 页码: 916-921 栏目: 专题·儿童陈旧性孟氏骨折 出版日期: 2019-11-30
Title:
Risk factors of pediatric neglected Monteggia fracture and Kim or Mayo Elbow performance score
作者:
张瑾1; 9;  蒋飞1; 9;  王帅印2; 9;  邵景范3; 9;  梅海波4; 9;  郭跃明5; 9;  唐欣6; 9;  徐宏文7; 9;  黎艺强7; 9;  沈先涛8; 9
1. 大连医科大学附属大连市儿童医院(辽宁省大连市, 116012);
2. 深圳市儿童医院(深圳市, 518000);
3. 华中科技大学同济医学院附属同济医院(湖北省武汉市, 430030);
4. 湖南省儿童医院(湖南省长沙市, 410007);
5. 佛山市中医院(广东省佛山市, 528000);
6. 华中科技大学同济医学院附属协和医院(湖北省武汉市, 430030);
7. 广州市妇女儿童医疗中心(广东省广州市 510623);
8. 武汉市妇女儿童医疗保健中心(湖北省武汉市, 430030);
9. 中国儿童骨科多中心研究协作组
Author(s):
Zhang Jin1; 9;  Jiang Fei1; 9;  Wang Shuaiyin2; 9;  Shao Jingfan3; 9;  Mei Haibo4; 9;  Guo Yueming5; 9;  Tang Xin6; 9;  Xu Hongwen7; 9;  Li Yiqiang7; 9;  Shen Xiantao8; 9
1. Department of Pediatric Orthopedics, Affiliated Dalian Children’s Hospital, Dalian Medical University, Dalian 116012, China;
2. Municipal Children’s Hospital, Shenzhen 518000, China;
3. Affiliated Tongji Hospital, TongJi Medical College, Huazhong University of Science & Technology, Wuhan 430030, China;
4. Hunan Province Children’s Hospital, Changsha 410007, China;
5. Foshan Hospital of Traditional Chinese Medicine. Foshan 528000, China;
6. Xiehe Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China;
7. Department of Pediatric Orthopedics, Municipal Women & Children’s Medical Center, Guangzhou Medical University, Guangzhou 510623, China;
8. Municipal Women & Children Medical Care Center, Wuhan 430030, China;
9. Chinese Pediatric Orthopedics Multicenter Clinical Study Group
关键词:
孟氏骨折; 预后; 因素分析; 统计学; 儿童
Keywords:
Monteggia Fracture; Prognosis; Factor Analysis;  Statistical; Child
分类号:
R726.8;R683
DOI:
10.3969/j.issn.1671—6353.2019.11.005
摘要:
目的 对儿童陈旧性孟氏骨折术后患儿进行Kim评分及Mayo肘关节评分，探讨陈旧性孟氏骨折患儿预后的影响因素，为临床工作提供参考。方法 统计自2010年1月至2018年12月中国儿童骨科多中心研究协作组收治的陈旧性孟氏骨折患儿基本资料，并进行术后随访，统计肘关节Kim评分及Mayo评分，采用SPSS 19.0对影响肘关节功能的因素进行统计学分析。结果 本研究共统计陈旧性孟氏骨折患儿119例，随访90例（随访率75.63%），中位随访时间3.14年（6个月至8年）。术后Mayo评分等级为：优80例，良1例，可8例，差1例，优良率90%。术后Kim评分等级为：优71例，良3例，可11例，差5例，优良率为82.22%。二者评估结果无统计学差异（χ2=2.276，P=0.131）。影响肘关节Mayo评分的因素为：手术距受伤时间（χ2=13.188，P<0.001），是否行尺骨截骨（χ2=5.556，P=0.018）；影响肘关节Kim评分的因素为：是否行尺骨截骨（χ2=4.331，P=0.037）。结论 影响陈旧性孟氏骨折预后的主要因素包括受伤距手术时间以及是否行尺骨截骨，肘关节Kim评分及Mayo评分对患儿预后状况的评估结果一致性较好。
Abstract:
Objective To explore the risk factors influencing the recovery of pediatric neglected Monteggia fracture so as to provide rationales for clinical practice.Methods The basic data of 119 children of neglected Monteggia fracture from January 2010 to December 2018 were collected and postoperative follow-ups conducted.The Kim and Mayo elbow performance scores were calculated.Results A total of 90 children (male-to-female ratio:2:1) were followed-up.The median postoperative follow-up period was 3.14 (0.5-8.0,±1.8573) years.The Mayo score after treatment was excellent (n=80,decent (n=1),fair (n=8) and poor.(n=1).Original injury to surgery interval and ulna osteotomy were risk factors (P<0.05) and the major factors were original injury to surgery interval and ulna osteotomy after logistic analysis (P<0.05).The Kim score after treatment was excellent (n=71),decent (n=3),fair (n=11) and poor (n=5).Original injury to surgery interval and ulna osteotomy were risk factors (P=0.05) and the major factors were original injury to surgery interval and ulna osteotomy based upon Logistic analysis (P<0.05).Conclusion The major influencing factors for the recovery of pediatric neglected Monteggia fracture include original injury to surgery interval and ulna osteotomy.No significant difference exists in elbow Kim or Mayo score.

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备注/Memo

收稿日期:2019-09-24。
通讯作者:蒋飞,Email:jf2299@163.com

更新日期/Last Update: 1900-01-01