Jiang Enzhe,Ge Yihua,Shen Kaiying.Closed reduction plus single intramedullary Kirschner wire fixation for type Ⅱ phalangeal neck fractures in children[J].Journal of Clinical Pediatric Surgery,2022,21(01):74-77.[doi:10.3760/cma.j.cn.101785-201911042-014]
单枚克氏针髓内穿梭法闭合复位内固定治疗儿童Ⅱ型指骨颈骨折
- Title:
- Closed reduction plus single intramedullary Kirschner wire fixation for type Ⅱ phalangeal neck fractures in children
- Keywords:
- Phalangeal Neck Fractures; Fracture Fixatio; Internal Fixators; Child
- 摘要:
- 目的 探讨采用闭合复位单枚克氏针髓内穿梭法内固定治疗儿童Ⅱ型指骨颈骨折的临床疗效与优势。方法 以上海交通大学医学院附属上海儿童医学中心骨科2017年1月至2019年1月收治的13例采用闭合复位单枚克氏针髓内穿梭法内固定手术治疗的儿童Al-Qattan Ⅱ型指骨颈骨折患儿为研究对象，手术指征为：骨折线位于指骨颈、伴远端骨折移位，但仍存在骨折端骨性接触； 骨折仅累及指骨颈，指骨头完整。统计患儿基本信息及手术时间、术后功能、术后并发症、术后儿童改良DASH评分等指标。结果 患儿平均年龄（7.5±4.1）岁，平均随访（10.5±7.5）个月，术中平均用时（11.1±6.2）min。直至末次随访，所有骨折均获得良好愈合，平均骨折临床愈合时间（4.2±1.1）周，平均内固定时间（5.1±1.2）周。内固定取出后平均（3.5±1.5）周骨折远端指间关节恢复无痛屈伸活动，1例患指残余轻度旋转畸形，无一例出现骨不连、骨慢连、指骨头缺血性坏死及骺板早闭等并发症。术后改良DASH评分的平均值为1.7分（0~6.0分），显示功能预后良好。结论 单枚克氏针髓内穿梭法闭合复位内固定手术是治疗儿童Ⅱ型指骨颈骨折操作简便且安全有效的手术方式。
- Abstract:
- Objective To evaluate the efficacies and advantages of closed reduction plus single intramedullary Kirschner wire fixation for type Ⅱ phalangeal neck fractures in children. Methods From January 2017 to January 2019, clinical data were retrospectively reviewed for 13 hospitalized children with Al-Qattan type Ⅱ phalangeal neck fractures.Operative duration, postoperative outcomes and complications were recorded. Results The average age was (7.5±4.1) years, the average follow-up period (10.5±7.5)(6-28) months and the average operative duration (11.1±6.2) min.All fractures were well healed at the last follow-up.The average fracture healing time was (4.2±1.1) weeks, and the average internal fixation time (5.1±1.2) weeks.After removal of internal fixation, interphalangeal joint resumed painless flexion and extension within (3.5±1.5) weeks.Only one child had mild rotational residual deformity.None of them had nonunion, slow union, avascular necrosis or premature closure of growth plate. Conclusion Closed reduction plus single intramedullary fixation is both safe and effective for type II phalangeal neck fractures in children.
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备注/Memo
收稿日期:2019-11-19。
基金项目:上海市卫生和健康委员会项目（20184Y0133）
通讯作者:沈恺颖,Email:skyscmc@163.com