两种不同克氏针固定方式治疗儿童CampbellⅡ型近节指骨骺旁骨折的疗效比较
Comparison of two modalities of Kirschner pin fixation for severely displaced(Campbell type Ⅱ)jux-ta-epiphyseal fracture of the proximal phalanx in children
王帅印 1黄子龙 1李佳卉 1付桂兵1
作者信息
- 1. 深圳市儿童医院骨科,深圳 518000
- 折叠
摘要
目的 比较两种不同克氏针固定方式治疗儿童Campbell Ⅱ型(严重移位)近节指骨骨骺旁骨折的疗效.方法 回顾性分析2018年1月至2020年12月在深圳市儿童医院骨科治疗的69例儿童Campbell Ⅱ型近节指骨骺旁骨折患儿资料.男41例,女28例;年龄(7.6±3.2)岁;左手34例,右手35例;拇指4例,中指4例,环指5例,小指56例.根据克氏针内固定方式不同分为2组:A组(35例35指采用闭合复位单枚克氏针纵向髓内固定联和石膏外固定治疗),B组(34例34指采用闭合复位2枚克氏针交叉固定联和石膏外固定治疗).比较两组患儿术前骨折成角角度、手术时间、术后骨折成角角度、住院时间、术后功能恢复情况.结果 两组患儿术前一般资料比较差异均无统计学意义(P＞0.05),具有可比性.所有患儿骨折均获愈合,愈合时间为3～6周.两组患儿在术前骨折成角角度、手术时间、术后骨折成角角度上差异无统计学意义(P＞0.05).A组患儿住院时间较B组短,差异有统计学意义(P＜0.05).50例患儿获(54.3±10.5)个月随访,其中A组24例,B组26例.末次随访时按手功能评定试用标准:A组优24例,优良率100％(24/24);B组优26例,优良率100％(26/26),差异无统计学意(P＞0.05).术后无一例患儿发生克氏针断裂、针道感染、明显成角畸形、旋转畸形、骨桥形成等并发症.结论 对于儿童近节指骨Campbell Ⅱ型骨骺旁骨折,单枚克氏针纵向髓内固定与2枚克氏针交叉固定在骨折稳定性和功能方面效果相当,但前者患儿住院时间更短.
Abstract
Objective To compare 2 modalities of Kirschner pin fixation for severely displaced(Campbell type Ⅱ)juxta-epiphyseal fracture of the proximal phalanx in children.Methods A retrospec-tive study was conducted to analyze the clinical data of 69 children with severely displaced(Campbell type Ⅱ)juxta-epiphyseal fracture of the proximal phalanx who had been treated at Department of Orthopaedics,Shen-zhen Children's Hospital from January 2018 to December 2020.Clinical data:41 boys and 28 girls;(7.6±3.2)years in age;34 left hands and 35 right hands affected;4 thumbs,4 middle fingers,5 ring fingers,and 56 little fingers injured.The patients were divided into 2 groups according to surgical modalities.Group A(35 fingers in 35 cases)was treated by closed reduction,longitudinal intramedullary fixation with a single Kirschner pin,and external plaster fixation while group B(34 fingers in 34 cases)by closed re-duction,crossing fixation with 2 Kirschner pins,and external plaster fixation.The 2 groups were compared in terms of preoperative fracture angulation,operation time,postoperative fracture angulation,hospitaliza-tion days,and postoperative functional recovery.Results There was no statistically significant differ-ence in the preoperative general data between the 2 groups,indicating comparability(P＞0.05).All fractures got united after 3 to 6 weeks.There was no statistically significant difference between the 2 groups in terms of preoperative fracture angulation,operation time,or postoperative fracture angulation(P＞0.05).The hospitalization days in group A were significantly shorter than that in group B(P＜0.05).Fifty children(24 cases in group A and 26 cases in group B)were followed up for(54.3±10.5)months.By the trial crite-ria for upper limb functional evaluation of the Hand Surgery Society,the hand function was evaluated at the last follow-up as excellent in 24 cases in group A,giving an excellent rate of 100％(24/24),and as ex-cellent in 26 cases in group B,giving an excellent rate of 100％(26/26)too,showing no significant differ-ence between the 2 groups(P＜0.05).No postoperative complications such as Kirschner wire breakage,nee-dle tract infection,significant angular deformity,rotational deformity,or bone bridge formation occurred in any of the patients.Conclusion For children with severely displaced(Campbell type Ⅱ)juxta-epiphyseal fracture of the proximal phalanx,longitudinal intramedullary fixation with a single Kirschner pin and crossing fixation with 2 Kirschner pins may achieve comparable efficacy in terms of fracture stability and function,but the former may result in shorter hospitalization days.
关键词
儿童/指骨/骨折固定术,内/克氏针/骨骺旁骨折Key words
Child/Finger phalanges/Fracture fixation,internal/Kirschner pin/Juxtaepi-physeal fracture引用本文复制引用
出版年
2024
NETL
NSTL
万方数据