| 经皮克氏针固定治疗严重移位儿童胫骨下端骨折 |
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投稿时间：2013-08-07
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| 作者 | Author | 单位 | Address | E-Mail |
| 叶聪聪 |
YE Cong-cong |
温州医学院附属二院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Hospital Affiliated to Wenzhou Medical College, Wenzhou 325027, Zhejiang, China |
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| 赵友明 |
ZHAO You-ming |
温州医学院附属二院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Hospital Affiliated to Wenzhou Medical College, Wenzhou 325027, Zhejiang, China |
ymzhao710@163.com |
| 郭伟军 |
GUO Wei-jun |
温州医学院附属二院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Hospital Affiliated to Wenzhou Medical College, Wenzhou 325027, Zhejiang, China |
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| 陈林 |
CHEN Lin |
温州医学院附属二院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Hospital Affiliated to Wenzhou Medical College, Wenzhou 325027, Zhejiang, China |
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| 杨翔 |
YANG Xiang |
温州医学院附属二院骨科, 浙江 温州 325027 |
Department of Orthopaedics, the Second Hospital Affiliated to Wenzhou Medical College, Wenzhou 325027, Zhejiang, China |
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| 期刊信息：《中国骨伤》2014年，第27卷，第8期，第691-693页 |
| DOI：10.3969/j.issn.1003-0034.2014.08.017 |
| 基金项目: |
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中文摘要:
目的：探讨利用手法复位、经皮克氏针固定治疗严重移位的儿童胫骨下端骨折的疗效。
方法：自2009年5月至2012年12月，利用手法复位、经皮克氏针固定治疗儿童胫骨下端骨折56例，术前均行骨折端X线检查，证实均为严重移位骨折。其中男33例，女23例；年龄3~14岁，平均10.1岁。所有骨折为闭合性骨折，不伴血管神经损伤。根据骨折类型及移位情况，在C形臂X线机透视下行手法复位，复位成功后对两骨折端经皮克氏针固定， 术后石膏固定4~6周。详细记录术中情况、术后并发症及远期随访结果，包括X线检查结果、踝关节活动范围及胫骨长度，最后以Teeny踝关节功能评分评价疗效。
结果：56例患儿中45例成功随访，时间3~46个月，平均19.4个 月。在末次随访时，予踝关节功能Teeny评分：优35例，良7例，可3例。X线片示所有病例达骨性愈合，愈合时间8~12周，未出现骨骺早闭，无胫骨短缩、成角畸形，术后出现克氏针针道反应4例。术后3个月，所有患儿可以正常步行，踝关节功能基本恢复至正常。
结论：手法复位、经皮克氏针固定治疗严重移位的儿童胫骨下端骨折是一种简便、安全的手术方式，微创，对软组织损伤小，固定牢靠，可早期功能锻炼，疗效满意，是一种行之有效的治疗方法。 |
| 【关键词】胫骨骨折 儿童 骨折固定术 |
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| Manipulative reduction and percutaneous pin fixation for the treatment of severely displaced distal tibial fractures in children |
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ABSTRACT
Objective: To study the therapeutic efficacy of manipulative reduction and percutaneous pin fixation for the treatment of severely displaced distal tibial fractures in children.
Methods: From May 2009 to December 2012,56 children with severely displaced distal tibial fractures were analyzed,who had been treated with manipulative reduction and percutaneous pin fixation. Preoperative fractures were confirmed as severely displaced fractures by X-ray apparatus. There were 33 boys and 23 girls,ranging in age from 3 to 14 years,with an average of 10.1 years. All the fractures were closed without vascular or nerve injuries. According to the bone fracture type,under C-arm fluoroscopy,functional reduction was achieved by manipulative reduction. The fractures were fixed with percutaneous pins. Postoperative X-ray confirmed the functional reduction. Follow-up indexes were recorded:intra-operative and postoperative complications,postoperative radiographic examination,lower extremity length and range of ankle motion. Ankle score system of Teeny was used to evaluate ankle function.
Results: All the patients were followed up,and the duration ranged from 3 to 46 months,with an average duration of 19.4 months. According to the Teeny score standard,35 patients got an excellent result,7 good and 3 fair. Pin track reaction was found in 4 cases. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. All the patients could participate in the normal physical activities,having a normal range of motion and excellent strength of the ankle joint.
Conclusion: The method of manipulative reduction and percutaneous pin fixation is a safe and convenient treatment for severely displaced distal tibial fractures in children. It has several advantages as follow:micro-trauma,tiny tissue damage,firm fixation,and the patients can exercise the function of ankle early,suggesting that it is an effective treatment method. |
| KEY WORDS Tibial fractures Child Fracture fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 叶聪聪,赵友明,郭伟军,陈林,杨翔.经皮克氏针固定治疗严重移位儿童胫骨下端骨折[J].中国骨伤,2014,27(8):691~693 |
| 英文格式: | YE Cong-cong,ZHAO You-ming,GUO Wei-jun,CHEN Lin,YANG Xiang.Manipulative reduction and percutaneous pin fixation for the treatment of severely displaced distal tibial fractures in children[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(8):691~693 |
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