【摘要】 目的评价避开骨骺克氏针经皮质内固定法治疗儿童尺骨桡骨远端骨折的疗效。方法回顾性分析1996~2005年本院治疗桡骨、尺桡骨远端骨折患儿的临床和随访资料,采取小切口切开复位克氏针固定并全程随访91例。按克氏针安放方法分2组。A组:53例避开骨骺克氏针经骨皮质固定法;B组:38例髓内克氏针经骨骺固定法。均随访6~100个月,对术中反复操作、骨折解剖复位、术后再移位、克氏针移位、感染、腕功能受限及骺板骨桥资料对比分析。结果二组骨折复位效果均良好,固定良好,完全愈合,愈合率无差异;再移位率、克氏针移位率和感梁率均较低,且无差异;术中反复操作率、腕功能受限率、骨骺损伤率有显著性差异,B组高于A组。结论儿童尺骨桡骨远端骨折内固定时,避开骨骺克氏针经骨皮质内固定更符合儿童解剖特点,固定可靠,疗效符合临床要求,并发症少,优于髓内经骨骺固定法。更多还原

【Abstract】 Objective To investigate and assess the clinical effect of treatment of children′s fractures at distal radial or radial-ulna through incision and Kirschner wire′s interior fixation without coursing epiphysis.Methods The treatment of children′s fractures at distal radial or radial-ulna in our hospital between 1996 and 2005 were reviewed,91 cases via Kirsehner-wire′s internal fixation were dealt.According to the way of placing Kirschner wire,the patients were divided into 2 groups.Group A of 53 cases eschewing epiphysis and passed bone-cortex.Group B of 38 cases got intramedullary fixation and passed epiphysis for 38 cases.After 6-100 months′ follow-up investigation,the 2 groups were comporred by analyzing statistics and the number of cases which involved repeatedly setting of Kirschner wire during operation,anatomical restoration,replacement,Kirschner-wire moving,infection,wrist′s dysfunction and bridge between the epiphysis.Results The fractures in both groups were recovering well.Besides,both were at the low rate of repeated replacement,Kirschner wire moving and infection.However,there were significant differences on repeated setting of Kirschner wire during operation,wrist′s dysfunction and bridge between the epiphysis,of which group B were higher than those in group A.Conclusions While the children′s fractures at distal radial or radial-ulna will be reduced by incision and fixing with Kirschner wire,the way of eschewing epiphyses and passing bone-cortex is better because it accords with anatomic character of children.It can not only fix reliably and bring satisfying clinical treatment effect,but also cause little complication.Thus,it is superior to the way of intramedullary fixation and passed epihysis.更多还原