| 自制克氏针钩固定治疗严重移位儿童肱骨近端骨折 |
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Received:July 20, 2013
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| 期刊信息：《中国骨伤》2014年27卷，第7期，第579-582页 |
| DOI：10.3969/j.issn.1003-0034.2014.07.011 |
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目的：探讨自制克氏针钩治疗严重移位的儿童肱骨近端骨折的临床疗效。
方法：2007年1月至2012年2月，应用自制克氏针钩治疗严重移位的儿童肱骨近端骨折35例，男25例，女10例；年龄5～17岁，平均13.2岁；伤后至手术时间1～10 d，平均4.5 d.骨折移位根据Neer-Horwitz分型，Ⅲ型26例，Ⅳ型9例。均为闭合性骨折，无神经血管损伤。手术均行切开复位，复位满意后行自制克氏针钩固定。观测记录术中及术后并发症、术后放射学检查结果、上肢长度及肩关节活动度，并以Neer肩关节功能评分标准对肩关节功能进行评分。
结果：35例获得随访，时间6～18个月，平均12.1个月。末次随访时肩关节功能Neer评分84～99分，平均（94.2±4.8）分，优30例，良5例；X线片显示所有病例骨性愈合，未发现内固定物松动断裂等并发症，无骨骺早闭现象，无肢体短缩畸形。除外展外患侧肩关节各方向活动度与正常侧肩关节相同（P>0.05）.所有患者能参加正常的体育活动。
结论：自制克氏针钩固定是一种安全、有效的治疗严重移位的儿童肱骨近端骨折的方法。 |
| [关键词]:肱骨骨折 儿童 骨折固定术，内 |
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| Self-made Kirschner wire hook for the treatment of severe displaced proximal humeral fractures in children |
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Abstract:
Objective: To explore the clinical efficacy of self-made Kirschner wire hook in the treatment of severely displaced proximal humerus fractures in children.
Methods: From January 2007 to February 2012,35 children with severely displaced proximal humerus fractures were treated with self-made Kirschner wire hook fixation,including 25 boys and 10 girls with an average age of 13.2 years old ranging from 5 to 17. The duration from injury to operation was 1 to 10 days with an average of 4.5 days. Preoperative diagnoses were confirmed by X-ray films as type Ⅲ in 26 cases and type Ⅳ in 9 according to the Neer-Horwitz classification of the proximal humerus fractures. All fractures were close fracture without nerve or vascular injuries. Anatomical reduction was achieved by open reduction and the fractures were fixed by self-made Kirschner wire hook. Intra-operative and postoperative complications,postoperative radiographic examination,upper extremity length and range of shoulder motion were observed and recorded. Neer score system was used to evaluate shoulder function.
Results: All patients were followed up from 6 to 18 months with an average of 12.1 months. The mean Neer score of the injured side was 94.2±4.8 (ranged,84 to 99),30 patients got an excellent result and 5 good according to the Neer scores. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. There were no complications related to the implant including loosening or breakage of the self-made Kirschner wire hook. The range of shoulder motion in the injuried side was similar to the normal side,except in abductor lift. All the patients could participate in normal physical activities.
Conclusion: The method of open reduction and fixed with self-made Kirschner wire hook is a safe,effective,convenient treatment for severely displaced proximal humeral fractures in children. |
| KEYWORDS:Humeral fractures Child Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赵波,冉霞,张铭华,蒋电明,何超.自制克氏针钩固定治疗严重移位儿童肱骨近端骨折[J].中国骨伤,2014,27(7):579~582 |
| 英文格式: | ZHAO Bo,RAN Xia,ZHANG Ming-hua,JIANG Dian-ming,HE Chao.Self-made Kirschner wire hook for the treatment of severe displaced proximal humeral fractures in children[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(7):579~582 |
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