儿童跟骨骨折超声引导闭合复位经皮克氏针固定
Ultrasound-guided closed reduction and percutaneous Kirschner wire fixation for calcaneal fractures in children
于佳 1袁馨 1赵璐 1李绚璇 1杨浩2
作者信息
- 1. 青岛大学附属青岛市中医医院功能检查科,山东青岛 266033
- 2. 青岛大学附属青岛市中医医院骨科,山东青岛 266033
- 折叠
摘要
[目的]探究超声引导闭合复位经皮克氏针固定儿童跟骨骨折的临床疗效.[方法]回顾性分析本院2020年1月—2022年8月收治的100例跟骨骨折患儿的临床资料,均接受闭合撬拨复位克氏针内固定治疗,根据医患沟通结果,超声引导下操作55例(超声组),透视下操作45例(透视组).对比两组患儿围手术期、随访及影像资料.[结果]超声组手术时间[(35.0±6.8)min vs(58.2±10.4)min,P＜0.001]、影像检查时间[(325.0±25.6)s vs(600.5±73.5)s,P＜0.001]、术中透视次数[(2.7±0.8)次vs(10.2±2.8)次,P＜0.001]、下地行走时间[(3.0±0.5)d vs(3.5±1.0)d,P=0.002]及住院时间[(4.5±1.6)d vs(5.4±2.0)d,P=0.014]均显著优于透视组.与术后1个月相比,末次随访时两组VAS评分、AOFAS评分、踝背伸-跖屈及内-外翻ROM均显著改善(P＜0.05);术后1个月,超声组VAS评分显著优于透视组[(2.0±0.6)vs(2.3±0.7),P=0.023],其他相应时间点,两组间上述指标的差异均无统计学意义(P＞0.05).影像方面,随时间推移,两组Bohler角、Gissane角、关节软骨塌陷高度均显著改善(P＜0.05).术后1个月超声组关节软骨塌陷高度[(2.0±0.7)mm vs(2.5±0.6)mm,P＜0.001]显著小于透视组,相应时间点,两组间其他影像指标的差异均无统计学意义(P＞0.05).[结论]超声引导闭合复位内固定治疗儿童跟骨骨折疗效较好,相比透视下操作具有手术时间短、辐射损伤小、术中出血量少的优点.
Abstract
[Objective]To explore the clinical efficacy of ultrasound-guided closed reduction and percutaneous Kirschner wire fixation for calcaneal fractures in children.[Methods]A retrospective study was conducted on 100 children admitted into our hospital for calcaneal fractures from January 2020 to August 2022.All of them received closed prying reduction and percutaneous Kirschner wire fixation.Ac-cording to preoperative doctor-patient communication,55 cases had operation performed under ultrasound guidance(ultrasound group),while other 45 cases were under fluoroscopy(fluoroscopy group).The perioperative,follow-up and imaging data of the two groups were com-pared.[Results]The ultrasound group proved significantly superior to the fluoroscopy group in terms of operation time[(35.0±6.8)min vs(58.2±10.4)min,P＜0.001]and imaging check time[(325.0±25.6)s vs(600.5±73.5)s,P＜0.001],intraoperative fluoroscopy times[(2.7±0.8)times vs(10.2±2.8)times,P＜0.001],walk time[(3.0±0.5)days vs(3.5±1.0)days,P=0.002]and hospital stay[(4.5±1.6)days vs(5.4±2.0)days,P=0.014].Compared with those 1 month after surgery,the VAS score,AOFAS score,ankle dorsal-plantar flexion and inversion-ever-sion range of motions(ROMs)significantly improved in both groups at the last follow-up(P＜0.05).One month after surgery,the VAS score in the ultrasound group was significantly better than that in the fluoroscopy group[(2.0±0.6)vs(2.3±0.7),P=0.023],whereas at other corre-sponding time points,there was no statistical significance in the above indexes between the two groups(P＞0.05).Regarding imaging,the Bohler's angle,Gissane's angle and articular cartilage collapse height were significantly improved over time in both groups(P＜0.05).The articular cartilage collapse height in the ultrasound group was significantly lower than that in the fluoroscopy group one month after surgery[(2.0±0.7)mm vs(2.5±0.6)mm,P＜0.001],regardless of no statistically significant differences in other imaging indicators between the two groups at any corresponding time points(P＞0.05).[Conclusion]Ultrasound-guided closed reduction and percutaneous Kirschner wire fixa-tion has the advantages of shorter operation time,less radiation damage and less intraoperative bleeding over the fluoroscopy-guided coun-terpart for calcaneal fractures in children.
关键词
儿童/跟骨骨折/超声/闭合复位/经皮克氏针固定Key words
children/calcaneal fracture/ultrasound/closed reduction/percutaneous Kirschner wire fixation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据