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弹性髓内钉治疗大龄儿童锁骨骨折的临床疗效
Hits: 2331   Download times: 1552   Received:September 20, 2014    
作者Author单位UnitE-Mail
许国军 XU Guo-jun 温州医科大学附属义乌医院骨科, 浙江 义乌 322000 Department of Orthopaedics, the Yiwu Affiliated Hospital of Wen-zhou Medical University, Yiwu 322000, Zhejiang, China  
吴国林 WU Guo-lin 温州医科大学附属义乌医院骨科, 浙江 义乌 322000 Department of Orthopaedics, the Yiwu Affiliated Hospital of Wen-zhou Medical University, Yiwu 322000, Zhejiang, China wuguolin221221@163.com 
陈旭宏 CHEN Xu-hong 温州医科大学附属义乌医院骨科, 浙江 义乌 322000 Department of Orthopaedics, the Yiwu Affiliated Hospital of Wen-zhou Medical University, Yiwu 322000, Zhejiang, China  
季向荣 JI Xiang-rong 温州医科大学附属义乌医院骨科, 浙江 义乌 322000 Department of Orthopaedics, the Yiwu Affiliated Hospital of Wen-zhou Medical University, Yiwu 322000, Zhejiang, China  
黄洪斌 HUANG Hong-bing 温州医科大学附属义乌医院骨科, 浙江 义乌 322000 Department of Orthopaedics, the Yiwu Affiliated Hospital of Wen-zhou Medical University, Yiwu 322000, Zhejiang, China  
陈超丽 CHEN Chao-li 温州医科大学附属义乌医院骨科, 浙江 义乌 322000 Department of Orthopaedics, the Yiwu Affiliated Hospital of Wen-zhou Medical University, Yiwu 322000, Zhejiang, China  
期刊信息:《中国骨伤》2015年28卷,第2期,第101-105页
DOI:10.3969/j.issn.1003-0034.2015.02.002


目的:研究弹性髓内钉闭合复位治疗大龄儿童锁骨骨折的应用和疗效.

方法:自2010年10 月至2012年12月,应用弹性髓内钉治疗16例大龄儿童锁骨骨折患者,男9例,女7例;年龄9~17岁,平均14.2岁;受伤至手术时间2~6 d.骨折类型:横形骨折13例,斜形3例(无长斜形骨折).分别比较健侧与患侧术后3个月随访时的肩关节Neer评分和术后3周的肩关节活动度,并通过X线片检查随访患者骨折愈合及复位情况.

结果:术后患儿伤口愈合良好,术后有2例出现皮肤激惹反应,没有出现感染、TEN断裂、骨折延迟愈合及顶破皮肤等并发症.所有患儿获得随访,时间3~10个月,平均7.2个月.术后3个月Neer评分96.69±6.22,与健侧98.75±2.70比较,差异无统计学意义(t=2.12,P>0.05).术后3周肩关节活动度与健侧比较差异有统计学意义(P<0.05).术后12~18周X线片显示骨性愈合后取出髓内钉,术后肩关节活动度恢复良好.

结论:弹性髓内钉具有损伤小、美观、固定可靠等优点,可为大龄儿童锁骨骨折提供一种较为理想的内固定方法.
[关键词]:锁骨  骨折  儿童  骨折固定术,髓内  外科手术
 
Therapeutic effects of titanium elastic nails for the treatment of clavicular fractures in elder children
Abstract:

Objective:To research the application and clinical effect of titanium elastic nails (TEN) for the treatment of closed clavicular fracture in elder children.

Methods:From October 2010 to December 2012,16 elderly children with clavicular fracture of elder children were treated with internal fixation,including 9 boys and 7 girls with an average age of 14.2 years old ranging from 9 to 17 years. The mean time between injury and surgery was 2 to 6 days. Thirteen patients had a transverse fractures; 3 patients had a oblique fractures,excluding the long-oblique patients. Neer function score after 3 months follow-up and the shoulder activity degree after 3 weeks followed were compared respectively between the injured side and healthy side. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with TEN technique.

Results:All patients were healed well after surgery. There were 2 cases with soft tissue irritation. No cases of infection,TEN broken,delayed healing or skin bursting were observed. All patients were followed up for 3 to 10 months,with an average of 7.2 months. There were no significant differences (t=2.12,P>0.05) between the healthy side (98.75±2.70) and injured side(96.69±6.22)of Neer score at 3 months during followed up. The shoulder activity at 3 weeks during followed up was different between both sides(P<0.05). The intramedullary nail was removed after X-rays at 12-18 weeks during followed up showed good bone healing,and the shoulder function was recovered well.

Conclusion:Internal fixation with TEN for the treatment of clavicular fracture has advantages of a limited invasion,beauty,safety and reliability. This technique provides an ideal fixation option for the treatment of clavicular fracture in elder children.
KEYWORDS:Clavicle  Fractures  Child  Fracture fixation,intramedullary  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:许国军,吴国林,陈旭宏,季向荣,黄洪斌,陈超丽.弹性髓内钉治疗大龄儿童锁骨骨折的临床疗效[J].中国骨伤,2015,28(2):101~105
英文格式:XU Guo-jun,WU Guo-lin,CHEN Xu-hong,JI Xiang-rong,HUANG Hong-bing,CHEN Chao-li.Therapeutic effects of titanium elastic nails for the treatment of clavicular fractures in elder children[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(2):101~105
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