尺骨截骨矫形后内固定与非内固定治疗儿童陈旧性孟氏骨折的疗效分析
《创伤外科杂志》[ISSN:/CN:]
- 期数:
- 2020年09期
- 页码:
- 660-664
- 栏目:
- 论著（临床研究）
- 出版日期:
- 2020-09-20
文章信息/Info
- Title:
- Analysis of the curative effect of internal fixation and non-internal fixation in the treatment of old Monteggia fractures in children after ulnar osteotomy and correction
- Author(s):
- XU Shi-bao; HAN Rui-ming; REN Xue-peng; QIN Xiao
- Department of Traumatology,Jiaozuo People's Hospital,Jiaozuo,Henan 454000,China
- 分类号:
- R 683.41; R 726.8
- DOI:
- 10.3969j.issn.1009-4237.2020.09.005
- 文献标识码:
- A
- 摘要:
- 目的 比较尺骨截骨矫形后内固定与非内固定治疗儿童陈旧性孟氏骨折的疗效。方法 回顾性分析2018年10月—2019年12月焦作市人民医院创伤显微骨科收治的陈旧性孟氏骨折的患儿38例,男性25例,女性13例; 年龄5～15岁,平均8.7岁。患儿均接受尺骨延长成角截骨治疗,依据接受术式的情况不同分为研究组(18例)和对照组(20例),研究组行尺骨延长成角截骨+非内固定治疗,对照组行尺骨延长成角截骨+内固定治疗。比较两组患儿围术期及随访期间(平均15.8个月)的治疗效果并行影像学评估。结果 研究组手术时间、术中出血量及尺骨愈合时间显著少于对照组[(33.67±8.18)min vs.(52.75±9.57)min、(131.86±22.13)mL vs.(236.92±59.97)mL、(7.06±0.87)周 vs.(8.65±1.45)周,P<0.05]。随访时间7～22个月,平均15.8个月; 末次随访时,两组患儿各评分均显著改善,且两组患儿VAS评分、Kim评分及Kim分级优良率比较差异无统计学意义(P>0.05)。两组患儿旋前弧度、屈伸弧度均显著改善且两组患儿间各活动指标比较差异无统计学意义(P>0.05)。结论 尺骨延长成角截骨非内固定手术有简便、安全、微创的优势,有利于缩减手术时间、规避手术损伤及术后不良反应的发生,是治疗儿童陈旧性孟氏骨折的理想手术方式。
参考文献/References
[1] Nakamura T.Distal metaphyseal shortening osteotomy of the ulna[J].J Wrist Surg,2019,8(5):351.
[2] Xu Z,Li Y,Wang Z,et al.Open reduction combined with CORA-based osteotomy of the ulna in the treatment of missed bado type I monteggia injury: a retrospective study of 5 cases[J].Medicine,2017,96(47): 860-862.
[3] 刘秋亮,张琰彬,史龙彦,等.小儿陈旧孟氏骨折手术方案荟萃分析[J].中华医学杂志,2018,98(38):3096-3101.
[4] Verhiel S,Özkan S,Eberlin K,et al.Nonunion and reoperation after ulna shortening osteotomy[J].Hand,2019,20(1):123-125.
[5] Nakura A,Kawabata H,Tamura D,et al.Focal fibrocartilaginous dysplasia in the ulna with the radial head dislocation: a case report and literature review[J].J Pediatr Orthop B,2017,26(1):86-88.
[6] Shrouder-Henry J,Novak CB,Jackson T,et al.Comparative study of early health care use after forearm corrective osteotomy[J].J Wrist Surg,2019,8(2):139-142.
[7] 石勇,陈子健,洪泽亚,等.三种内固定方法治疗老年股骨粗隆间骨折的临床价值对比分析[J].创伤外科杂志,2017,19(10):789-790.
[8] Cha SM,Shin HD,Ahn KJ.Prognostic factors affecting union after ulnar shortening osteotomy in ulnar impaction syndrome: a retrospective case-control study[J].J Bone Joint Surg,2017,99(8):638-647.
[9] Bakr MM,Kelly WL,Brunt AR,et al.A single injection of PTH improves osteoclastic parameters of remodeling at a stress fracture site in rats[J].J Orthop Res,2019,2(9):985-987.
[10] Ulici A,Florea DC,Tevanov I,et al.Surgical treatment of a rare "reverse" madelung deformity in 11 years female patient[J].Chirurgia,2017,112(1):72-76.
[11] Afshar A,Tabrizi A,Aidenlou A.Kienbock disease in a 66-year-old man after distal ulna fracture[J].J Hand Microsurg,2020,18(4):233-235.
[12] Hennrikus WL,Mehlman CT.The community orthopedic surgeon taking trauma call: pediatric distal radius and ulna fracture pearls and pitfalls[J].J Orthop Trauma,2019,33(8):6-11.
[13] Ciminero M,Yohe N,Garofolo-Gonzalez G,et al.Isolated distal ulna fracture with distal radioulnar joint dislocation: a novel fracture pattern[J].Hand,2019,4(2):155-159.
[14] Mespreuve M,Coenen L.The “second ulnar groove”,an MRI sign suggesting a previous palmar luxation of the ulna at the distal radioulnar joint[J].Eur Jf Radiol,2017,96(1):50-54.
[15] Miller A,Lightdale-Miric N,Eismann E,et al.Outcomes of isolated radial osteotomy for volar distal radioulnar joint instability following radial malunion in children[J].J Hand Surg,2017,43(1):81.
备注/Memo
- 备注/Memo:
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