经皮撬拨复位法治疗复位困难的小儿尺桡骨远端骨折

发布时间：2018-06-06 12:55

  本文选题：复位 + 儿童　； 参考：《承德医学院》2017年硕士论文

【摘要】：目的:这项研究的主要目的是评价经皮撬拨复位法治疗复位困难的小儿尺桡骨远端骨折的疗效。方法:选取2010年5月至2012年1月间收治的48名复位困难的尺桡骨远端骨折的患儿为研究对象,并对他们实施了经皮撬拨复位治疗。包括32名男孩和16名女孩,他们年龄为7-15岁,平均11岁,其中22名患儿的年龄不足9岁。在术后的随访中,腕关节的活动范围及手腕部的握力被充分评估,患侧的测量结果与健侧的测量结果也进行了系统的对比。腕关节功能根据Mayo wrist score评分表的标准来评估;肢体外观用visual analogue scale评分表来评估,患者对手术效果的满意度也可用此表评估,患者可根据自己的满意度给出0~10的评分。相关数据进行统计分析后的P值0.05被认为两种治疗方法具有统计学上的差异。结果:患者均取得骨折对位并愈合。骨折愈合时间:桡骨3~4周,平均3.5周;尺骨:3~4周,平均3.8周。经过36~45个月的术后随访,患者痊愈后,腕部屈曲活动范围为65°~86°,平均74°;伸直活动范围为54°~78°,平均66°。患侧手腕部的握力为13.8~47.6Kg,平均33.7Kg。腕关节功能评分为85~100分,平均97分,包括44例优秀与4例良好。患者的前臂外观得分为9~10分,平均9.7分,患者对术后伤肢功能的满意分数为8~10分,平均9.8分。骨折愈合后,所有患者的关节活动范围及手腕部的握力,与他们受伤前相比较,没有明显的减弱。结论:经皮撬拨复位法对于复位困难的小儿尺桡骨远端骨折是一项安全、有价值的手术治疗方法。
[Abstract]:Objective: to evaluate the efficacy of percutaneous prying reduction in the treatment of distal ulnar and radial fractures in children with difficult reduction. Methods: from May 2010 to January 2012 48 children with distal ulnar and radial fractures with difficult reduction were selected and treated with percutaneous prying reduction. They included 32 boys and 16 girls, aged 7-15, with an average age of 11, of whom 22 were under 9. During the follow-up, the range of wrist movement and the grip strength of the wrist were fully evaluated, and the measured results of the affected side were compared with those of the healthy side. Wrist function was evaluated according to the criteria of Mayo wrist score scale, limb appearance was evaluated by visual analogue scale, and patients' satisfaction with surgical effect was also evaluated by this table. Patients could give a score of 0 to 10 according to their own satisfaction. P 0.05 after statistical analysis of relevant data was considered to be statistically different between the two treatments. Results: all the patients obtained the fracture alignment and healed. Fracture healing time: radius 3 weeks, mean 3.5 weeks, ulna 3 weeks, mean 3.8 weeks. After 36 ~ 45 months follow-up, the range of wrist flexion activity was 65 掳/ 86 掳(mean 74 掳) and the range of extension was 54 掳/ 78 掳(mean 66 掳). The grip strength of the affected wrist was 13.8 and 47.6 kg, with an average of 33.7 kg. Wrist function score ranged from 85 to 100 with an average of 97, including 44 excellent and 4 good. The score of forearm appearance was 9 ~ 10 with an average of 9.7 points, and the satisfaction score of the patients with the function of injured limbs was 8 ~ 10, with an average of 9.8 points. After fracture healing, the range of joint motion and the grip strength of the wrist were not significantly decreased compared with those before the injury. Conclusion: percutaneous prying reduction is a safe and valuable surgical treatment for distal ulnar and radial fractures in children with difficult reduction.
【学位授予单位】：承德医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.8
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本文编号：1986591