CAJ | 학술논문

目的评价不同治疗方法治疗儿童前臂远端骨折的原则、可行性及疗效.方法选取2007年至2010年收治的儿童前臂远端骨折110例,临床资料完整,其中闭合复位外固定42例(A组),闭合复位经皮克氏针固定18例(B组),切开复位内固定50例(C组).根据Bohm复位评价标准,个体化治疗,随访2～5年按Berton愈后评价标准评价.结果 A组中1例患儿石膏固定l周后骨折发生移位,重新塑形石膏；1例患儿石膏固定2周后骨折发生移位,后行二次复位固定.C组中有2例发生再骨折,均行二次切开复位克氏针内固定.末次随访时,优93例,良12例,可5例,差0例.三组的愈后比较,差异无统计学意义(P＞0.05)；三组骨折类型分布与治疗方式的关联性分析,差异有统计学意义(P＜0.05).结论儿童前臂远端骨折常见,塑形能力强,愈后好,但不同类型的骨折治疗原则不尽相同,提倡个体化治疗.
목적 평개불동치료방법치료인동전비원단골절적원칙、가행성급료효.방법 선취2007년지2010년수치적인동전비원단골절110례,림상자료완정,기중폐합복위외고정42례(A조),폐합복위경피극씨침고정18례(B조),절개복위내고정50례(C조).근거Bohm복위평개표준,개체화치료,수방2～5년안Berton유후평개표준평개.결과 A조중1례환인석고고정l주후골절발생이위,중신소형석고；1례환인석고고정2주후골절발생이위,후행이차복위고정.C조중유2례발생재골절,균행이차절개복위극씨침내고정.말차수방시,우93례,량12례,가5례,차0례.삼조적유후비교,차이무통계학의의(P＞0.05)；삼조골절류형분포여치료방식적관련성분석,차이유통계학의의(P＜0.05).결론 인동전비원단골절상견,소형능력강,유후호,단불동류형적골절치료원칙불진상동,제창개체화치료.
Objective To present the principle,efficacy and feasibility of different methods in managing of distal forearm fracture in children.Methods From 2007 to 2010,110 patients with distal forearm fractures were retrospectively reviewed.We categorized the patients into 3 groups:group A (42 patients) underwent closed reduction and cast immobilization,group B(18 cases) underwent closed reduction and pin fixation,and group C (50 cases) underwent open reduction.All patients received individualized treatment according to Bohm's criteria.All cases were followed up for 2 to 5 years by Bertor's criteria.Results In group A,one suffered redisplacement of fractures one week after closed reduction and needed plaster re-moulding,and the other one suffered redisplacement two weeks after closed reduction and needed remanipulation and Kirschner wiring.In group C,2 cases suffered refracture and needed reduction and Kirschner wires fixation.At the end of follow-up,the results were excellent in 93 cases,good in 12 cases,and acceptable in 5 cases,without any unacceptable results.There were no differences of prognosis among three groups; however,the distribution of fracture patterns was significantly associated with treatment modalities.Conclusions Distal forearm fractures are extremely common with satisfactory remodeling and excellent functional recovery.However,therapeutic principles vary in different types of fractures,and individualized treatment is advocated.