CAJ | 학술논문

目的探讨超声在儿童桡骨颈骨折的诊断及治疗的价值,为桡骨颈骨折的微创治疗提供一种有效、安全、可靠的方法.方法 2012年8月至2014年5月,本院收治14例桡骨颈骨折患儿,其中O'BrienⅡ型10例,O'BrienⅢ型4例.均采用B型超声引导下经皮克氏针撬拨闭合复位,克氏针内固定石膏外固定.术后4～6周拆除石膏拔除克氏针开始功能锻炼.结果术后患儿均Ⅰ期愈合.14例均获得随访,随访时间最短6个月,最长23个月,平均随访时间10.6个月.术后X线片按Metaizeau等的标准评定,优12例,良2例,优良率100％.末次随访时,肘关节屈、伸、旋前、旋后活动度、提携角按Steel和Gtrham评分标准,优良率(100％).结论超声是一种无创检查技术,手术中通过超声引导,可以指导桡骨颈骨折的经皮克氏针撬拨,达到精确定位,具有微创、固定牢固、手术操作简便、允许术后早期活动、并发症少等优点.同时减少患儿及医务人员的X线暴露,具有良好的应用前景.
목적 탐토초성재인동뇨골경골절적진단급치료적개치,위뇨골경골절적미창치료제공일충유효、안전、가고적방법.방법 2012년8월지2014년5월,본원수치14례뇨골경골절환인,기중O'BrienⅡ형10례,O'BrienⅢ형4례.균채용B형초성인도하경피극씨침효발폐합복위,극씨침내고정석고외고정.술후4～6주탁제석고발제극씨침개시공능단련.결과 술후환인균Ⅰ기유합.14례균획득수방,수방시간최단6개월,최장23개월,평균수방시간10.6개월.술후X선편안Metaizeau등적표준평정,우12례,량2례,우량솔100％.말차수방시,주관절굴、신、선전、선후활동도、제휴각안Steel화Gtrham평분표준,우량솔(100％).결론 초성시일충무창검사기술,수술중통과초성인도,가이지도뇨골경골절적경피극씨침효발,체도정학정위,구유미창、고정뢰고、수술조작간편、윤허술후조기활동、병발증소등우점.동시감소환인급의무인원적X선폭로,구유량호적응용전경.
Objective To explore the ultrasonic images of radial neck fracture in children and evaluate the value of ultrasound in its diagnosis and treatment so as to provide an effective,safe and reliable method for its mini-invasive treatment.Methods A total of 14 patients of radial neck fracture were recruited.The types were O'Brien Ⅱ (n =10) and O'Brien Ⅲ (n =4).All patients underwent percutaneous Kirschner wire leverage (PKWL) guided by ultrasound,kirschner wire fixation and plaster external fixation.After 4-6 weeks later,functional exercise began after plaster removal and needle extraction.Results The average follow-up period was 10.6 (6-23) months.According to the postoperative X-ray by Metaizeau's standard,the outcomes were excellent (n =12) and fair (n =2).Based upon the Steel and Gtrham grading standard,elbow bending,stretching,pronation,supination activity and affirmative Angle were all excellent (100％) at the last follow-up.Conclusions As a noninvasive examination,ultrasound has great application prospects for percutaneous Kirschner wire leverage for accurate positioning in radial neck fracture.The advantages are mini-invasiveness,stable fixation,simple handling,early postoperative activity and fewer complications.Also it reduces the X-ray exposure of both children and medical staff.