克氏针内固定治疗小儿肱骨近端骨折

发布时间：2018-11-16 14:31

【摘要】：目的分析在克氏针在治疗儿童肱骨近端骨折的临床疗效及应用价值。方法回顾分析二零零五年一月至二零一一年十二月在重庆医科大学附属儿童医院行手术治疗的85例肱骨近端骨折患儿，均行手术切开复位，，并以克氏针固定，术后以外展支具固定。术后随访骨折愈合情况及肱骨生长情况。并嘱患儿行功能锻炼，随访患侧关节功能恢复情况。结果85例手术患儿均获得随访，术后平均随访10个月。全部病例骨折愈合，术后6-8周左右骨折处骨性愈合即可拔出克氏针。术后未发现一例肱骨头坏死、骨折再移位、骨不连，以及滑针、断针等并发症存在。以Constant-Murley肩关节功能评定方法作为疗效评定标准：优（大于90分）74例，良（80-89分）6例，一般（70-79分）5例，差（低于70分）0例，优良率达94%。结论在儿童肱骨近端骨折手术切开复位内固定中，应用克氏针作为固定材料，手术操作简单，固定较牢靠，对儿童骨骺损伤小，对周围组织（包括神经、血管）干扰较小，并且能早期进行肩关节功能锻炼，减轻术后肩关节周围组织的粘连。是治疗小儿肱骨近端骨折的一种良好方法。
[Abstract]:Objective to analyze the clinical effect and application value of Kirschner needle in the treatment of proximal humerus fracture in children. Methods from January 2005 to December 2011, 85 children with proximal humeral fractures were treated with open reduction and fixation with Kirschner needle. The external abductions were fixed after operation. Fracture healing and humeral growth were followed up. The children were given functional exercise to follow up the recovery of joint function in the affected side. Results 85 cases were followed up, the average follow-up was 10 months. All cases of fracture healing, 6-8 weeks after the fracture of bone healing can pull out Kirschner needle. No complications such as necrosis of the brachial head, redisplacement of fracture, nonunion, slide needle and broken needle were found after operation. Constant-Murley 's shoulder function evaluation was used as the criterion of curative effect: excellent (> 90) 74 cases, good (80-89) 6 cases, average (70-79) 5 cases, poor (less than 70) 0 cases. The excellent and good rate was 94. Conclusion in the open reduction and internal fixation of proximal humerus fracture in children, Kirschner's needle is used as the fixation material, the operation is simple, the fixation is reliable, the injury to epiphysis is small, and the interference to peripheral tissues (including nerve and blood vessel) is small. And early shoulder functional exercise to reduce postoperative adhesion around the shoulder. It is a good method to treat proximal humerus fracture in children.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R726.8

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