[1]袁荣霞,赵纯,谢正虎,等.折顶手法复位夹板外固定与手法闭合复位克氏针联合弹性髓内钉内固定治疗儿童尺桡骨远端双骨折的比较研究[J].中医正骨,2022,34(02):36-39+43.
 YUAN Rongxia,ZHAO Chun,XIE Zhenghu,et al.[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(02):36-39+43.
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折顶手法复位夹板外固定与手法闭合复位克氏针联合弹性髓内钉内固定治疗儿童尺桡骨远端双骨折的比较研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年02期
页码:
36-39+43
栏目:
临床研究
出版日期:
2022-02-20

文章信息/Info

Title:
作者:
袁荣霞赵纯谢正虎江继君
四川省骨科医院,四川 成都 610041
Author(s):
YUAN RongxiaZHAO ChunXIE ZhenghuJIANG Jijun
Sichuan Province Orthopedic Hospital,Chengdu 610041,Sichuan,China
关键词:
尺骨骨折 桡骨骨折 儿童 正骨手法 小夹板固定术 骨折固定术 骨钉 临床试验
Keywords:
ulna fractures radius fractures child bone setting manipulation small splint fixation fracture fixationinternal bone nails clinical trial
摘要:
目的:比较折顶手法复位夹板外固定与手法闭合复位克氏针联合弹性髓内钉内固定治疗儿童尺桡骨远端双骨折的临床疗效。方法:将192例尺桡骨远端双骨折患儿随机分为2组,每组96例,分别采用折顶手法复位夹板外固定(外固定组)与手法闭合复位克氏针联合弹性髓内钉内固定(内固定组)治疗。记录并比较2组患儿的骨折愈合时间,末次随访时采用Anderson前臂骨折疗效评价标准评价临床疗效。结果:所有患儿均获随访,随访时间3~4个月,中位数3.5个月。外固定组骨折愈合时间(30.40±2.10)d,内固定组骨折愈合时间(31.92±2.25)d; 2组患儿骨折愈合时间比较,差异无统计学意义(t=0.824,P=0.172)。末次随访时,外固定组临床疗效优83例、良10例、可3例,内固定组临床疗效优90例、良5例、可1例,2组患儿临床疗效比较,差异无统计学意义(Z=-1.698,P=0.089)。结论:折顶手法复位夹板外固定与手法闭合复位克氏针联合弹性髓内钉内固定治疗儿童尺桡骨远端双骨折,均有助于骨折早期愈合,且两者的临床疗效相当。
Abstract:
Objective:To compare the clinical outcomes of angulation-opposition manipulative reduction and external fixation with splint versus closed manipulative reduction and internal fixation with Kirschner-wires(K-wires)and elastic intramedullary nail in treatment of double fractures of distal ulna and radius in children.Methods:One hundred and ninety-two children with double fractures of distal ulna and radius were enrolled in the study and were randomly divided into external fixation group and internal fixation group,96 cases in each group.The children in external fixation group were treated with angulation-opposition manipulative reduction and external fixation with splint,while the ones in internal fixation group with closed manipulative reduction and internal fixation with K-wires and elastic intramedullary nail.The fracture healing time was recorded and compared between the 2 groups,and the clinical outcomes were evaluated according to Anderson therapeutic effect evaluation standard of forearm fracture at the last follow-up.Results:All children in the 2 groups were followed up for 3-4 months with a median of 3.5 months.The fracture healing time was 30.40±2.10 days in external fixation group and 31.92±2.25 days in internal fixation group.There was no statistical difference in fracture healing time between the 2 groups(t=0.824,P=0.172).At the last follow-up,83 children obtained an excellent result,10 good and 3 fair in external fixation group; while 90 children obtained an excellent result,5 good and 1 fair in internal fixation group.There was no statistical differences in the clinical outcomes between the 2 groups(Z=-1.698,P=0.089).Conclusion:The angulation-opposition manipulative reduction and external fixation with splint is similar to closed manipulative reduction and internal fixation with K-wires and elastic intramedullary nail in the clinical outcomes in treatment of double fractures of distal ulna and radius in children,and the both are beneficial to early fracture healing.

参考文献/References:

[1] 田伟.实用骨科学[M].北京:人民卫生出版社,2008:564-566.
[2] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:167.
[3] 刘枝城,董霞,陈启仪.手法复位配合夹板外固定治疗儿童桡骨远端骨骺骨折[J].中医正骨,2014,26(8):30-31.
[4] 胡永成,邱贵兴,马信龙,等.骨科疾病疗效评价标准[M].北京:人民卫生出版社,2012:34.
[5] 赵朝锋,赵俊峰,崔玉,等.平乐回旋拨槎法为主治疗儿童尺桡骨下段骨折68例[J].中国中医骨伤科杂志,2017,25(3):37-39.
[6] 吴声忠.儿童尺桡骨骨折手术治疗疗效探讨[J].中国中医骨伤科杂志,2016,24(4):61-62.
[7] 俞永智,刘杰,郭士方,等.弹性髓内针治疗儿童尺桡骨骨折[J].临床骨科杂志,2018,21(2):236-237.
[8] 周正虎,胡海洋,金光哲,等.小切口弹性髓内钉内固定治疗儿童尺桡骨骨折[J].临床骨科杂志,2018,21(6):695-698.
[9] 朱仲廉,官建中,朱坤.62例小儿前臂双骨折两种治疗方法的疗效观察[J].中华全科医学,2015,13(10):1614-1616.
[10] 韩赛平,郑许飞,李维,等.钛制弹性髓内钉治疗儿童前臂骨折的临床观察[J].创伤外科杂志,2017,19(1):43-45.
[11] 孙超俊,曹玉净,李扬,等.中医正骨手法联合弹性髓内钉固定儿童尺桡骨骨折[J].中医药临床杂志,2019,31(12):2331-2333.
[12] 王广伟,霍力为,庾伟中,等.手法复位夹板外固定治疗儿童前臂骨折[J].中医正骨,2016,28(12):52-54.
[13] 袁荣霞,董霞,赵纯,等.改良折顶手法复位小夹板固定治疗儿童尺桡骨远端双骨折[J].中医正骨,2015,27(8):18-19.
[14] 马奇翰,孟祥奇,俞鹏飞,等.折顶手法治疗儿童尺骨、桡骨下段双骨折临床观察[J].中医学报,2013,28(5):659-660.
[15] 谢正虎,董霞,袁荣霞,等.手法复位夹板外固定与切开复位克氏针内固定治疗儿童尺桡骨远端双骨折的对比研究[J].成都中医药大学学报,2017,40(3):72-75.
[16] GREEN N E,SWIONTKOWSKI M F.创伤骨科学:儿童卷[M].马信龙,冯世庆,李世民,等译.4版.天津:天津科技翻译出版有限公司,2016:175-176.
[17] 陈耀宗,孟祥奇,朱金琨,等.吴门医派正骨手法复位塑形纸夹板固定治疗儿童尺桡骨远端干骺端双骨折[J].中医正骨,2019,31(11):67-71.
[18] 张弛,方略,沈武俊,等.中医综合疗法治疗儿童尺桡骨双骨折67例临床观察[J].中医儿科杂志,2016,12(2):40-45.
[19] 徐平,董晓俊,鲁周同,等.折顶旋推手法治疗儿童尺桡骨远端背靠背骨折[J].中国骨伤,2015,28(9):864-867.
[20] 魏小强.分骨垫在普通小夹板外固定治疗儿童尺桡骨骨折中的应用[J].临床合理用药杂志,2017,10(25):38-39.
[21] 吴国芬,黄挺,郞永.分骨垫在儿童尺桡骨下段双骨折侧方移位矫正中的应用[J].中医正骨,2019,31(11):64-66.
[22] 王学昌,程方荣,郭会卿,等.儿童尺桡骨远端骨折背侧移位的发病及其诊治[J].中医正骨,2001,13(5):59-60.
[23] 齐建飞,万世奇,杨劼,等.儿童尺桡骨远干骺端(伸直型)完全骨折的治疗[J].实用骨科杂志,2018,24(12):1117-1119.
[24] 吕欣.儿童尺桡骨骨折保守治疗的效果观察[J].临床医药文献电子杂志,2019,6(61):11.
[25] 郭剑波,梁勇,李文新,等.手法复位小夹板固定治疗儿童尺桡骨远端骨折背侧移位[J].中医正骨,2019,31(2):58-60.
[26] 陈耀宗,孟祥奇.折顶手法复位塑形纸夹板固定治疗儿童尺桡骨中段双骨折[J].中医正骨,2019,31(8):52-56.

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备注/Memo

备注/Memo:
基金项目:四川省医学科研课题(S15069)
通讯作者:袁荣霞 E-mail:2508707056@qq.com
更新日期/Last Update: 2022-02-20