弹性髓内钉在小儿前臂双骨折中的应用

发布时间：2018-05-11 20:23

本文选题：小儿尺桡骨骨折 + 保守治疗　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的:比较三种不同的方法治疗小儿前臂双骨折的临床效果,为临床上小儿前臂双骨折治疗方法的选择提供参考。方法:前瞻性分析2012年9月-2017年1月甘肃省人民医院骨科门诊收治的48例尺桡骨骨折患儿的临床资料,以尺桡骨中段骨折为主,根据随机对照和盲法原则随机分为三组;A组:男9例,女7例,平均年龄(6.7±1.3)岁,采用保守治疗;B组:男9例,女7例,平均年龄(6.9±1.1)岁,采用弹性髓内钉进行治疗;C组:男8例,女8例,平均年龄(7.0±0.9)岁,采用钢板螺钉进行治疗。结果:A组患儿的骨折愈合时间为49.17±4.24天,治愈率为62.5%,不愈合率为6.2%,Anderson前臂骨折功能评分优良者占75%;并发症发生率为18.7%;B组患儿的骨折愈合时间为(35.01±3.29)d,治愈率为87.5%,不愈合率为0,Anderson前臂骨折功能评分优良者占93.7%;手术时间及术中出血量分别为(36.93±4.24)min和(14.15±2.86)m L;并发症发生率为6.25%;C组患儿的骨折愈合时间为(45.12±5.49)d,愈合率为62.5%,不愈合率为12.5%,Anderson前臂骨折功能评分优良者占87.5%;手术时间及术中出血量分别为(80.52±6.65)min和(154.31±16.86)m L A、B、C组两两相比,A与B及B与C间骨折愈合时间、愈合率、Anderson前臂骨折功能评分、并发症发生率均存在显著差异(P0.05),相比A和C,B组临床疗效更好。A与C组间骨折愈合时间、治愈率、Anderson前臂骨折功能评分均无统计学差异(P0.05);B与C两种手术治疗方法相比较,B组手术时间和术中出血量显著低于C组(P0.01)。结论:保守治疗、弹性髓内钉治疗及钢板螺钉治疗均能有效治疗尺桡骨骨折,然而与钢板螺钉治疗及保守治疗相比较而言,弹性髓内钉治疗具有切口损伤小、手术时间短、闭合复位成功率高、骨折愈合速度较快、再次拆除固定时损伤较小等优势。相对于保守治疗和弹性髓内钉手术治疗而言,骨折愈合时间短,治愈率高。因此,三种治疗方法中,弹性髓内钉临床治疗效果更好,并发症更少。
[Abstract]:Objective: to compare the clinical effects of three different methods for the treatment of double forearm fractures in children. Methods: the clinical data of 48 children with ulnar and radial fractures treated in Department of Orthopaedics of Gansu Provincial people's Hospital from September 2012 to January 2017 were analyzed prospectively. According to the principle of random control and blind method, three groups were randomly divided into three groups: male 9 cases, female 7 cases, mean age of 6.7 卤1.3 years old. Conservative treatment group B: male 9 cases, female 7 cases, mean age 6.9 卤1.1 years old, treated with elastic intramedullary nail in group C: male 8 cases. Female 8 cases, mean age was 7.0 卤0.9 years old, treated with plate and screw. Results the time of fracture healing in group A was 49.17 卤4.24 days. The cure rate was 62.5, the nonunion rate was 6.2Anderson forearm fracture, 75 patients had excellent functional score of forearm fracture, the complication rate was 18.7B, the healing time was 35.01 卤3.29 days, the cure rate was 87.5, and the nonunion rate was 0.Anderson forearm fracture functional score. The time and volume of intraoperative bleeding were 36.93 卤4.24)min and 14.15 卤2.86mLrespectively, the incidence of complications in group C was 6.25C, the healing time was 45.12 卤5.49nd, the healing rate was 62.5 and the non-union rate was 12.5Anderson 's forearm fracture functional score was 87.5mm; the operative time and intraoperative bleeding score were 87.5; The healing time of fracture between group A and B and between group B and C were 80.52 卤6.65)min and 154.31 卤16.86mL / L respectively. There were significant differences in the healing rate of Anderson's forearm fracture functional score and the incidence of complications (P 0.05). The healing time between group A and group C was better than that of group A and group C. There was no significant difference in the functional score of Anderson's forearm fracture between group B and group C. the operative time and blood loss in group B were significantly lower than those in group C (P 0.01). Conclusion: conservative treatment, elastic intramedullary nail treatment and plate and screw treatment can effectively treat ulnar and radial fractures, but compared with plate and screw treatment and conservative treatment, elastic intramedullary nail treatment has less incision injury and shorter operation time. The closed reduction rate is high, the fracture healing speed is faster, and the injury is less when the fixation is removed again. Compared with conservative treatment and elastic intramedullary nail surgery, fracture healing time is short and cure rate is high. Therefore, elastic intramedullary nail has better clinical effect and fewer complications.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.8

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