手法复位配合夹板外固定治疗儿童前臂骨折的疗效观察

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摘要目的探讨手法复位配合夹板外固定治疗儿童前臂骨折的临床疗效。方法将2017年3月至2018年9月广州中医药大学附属佛山中医院收治的68例符合纳入标准的前臂双骨折患者随机分为观察组与对照组，观察组采用手法复位夹板外固定治疗，共36例，男25例，女11例；年龄6~14岁，平均(10.63±3.72)岁；左侧13例，右侧23例；受伤至就诊时间2.5~19.0 h，平均(9.60±2.53)h。对照组采用弹性髓内钉内固定治疗，共32例，男23例，女9例；年龄7~14岁，平均(10.68±3.82)岁；左侧11例，右侧21例；受伤至就诊时间2.0~19.0 h，平均(9.86±2.38)h。观察并比较两组患者骨折愈合时间、治疗费用、住院天数、并发症情况等，按Anderson功能评定标准进行疗效评价。结果所有骨折在9~14周内愈合，平均12.15周，两组间愈合时间比较，差异无统计学意义(P＞0.05)；观察组治疗费用(2 232.61±81.75)元，低于对照组(15 730.25±835.52)元，差异有统计学意义(P＜0.05)；住院时间(6.39±2.43)d，短于对照组(13.16±2.78)d，并发症发生率16.67%，低于对照组53.13%，差异均有统计学意义(P＜0.05)；观察组优良率88.89%，对照组90.63%，两组比较差异无统计学意义(P＞0.05)。结论对于前臂骨折，手法复位夹板外固定与弹性髓内钉内固定治疗均可获得满意的疗效，但手法复位夹板外固定具有创伤小、操作简单、费用低、住院时间短、并发症少等优点，值得推广。

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	柯华荣 1
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	郭跃明 1*
	卢凤珊 1
	马洪 1

关键词 ：儿童, 前臂骨折, 手法复位, 夹板, 弹性髓内钉, 固定

Abstract：Objective To study the clinical efficacy of forearm fractures in children with the treatment of manual reduction and splint external fixation.Methods 68 patients who met the standard forearm fracture criteria were randomly divided into observation group(36 cases)and control group(32 cases).The observation group was treated with manual reduction splint external fixation.There was a total of 36 cases，including 25 males and 11 females，ranging from 6 to 14 in age，with an average of(10.63±3.72)years old.There were 13 cases on the left side and 23 cases on the right side.The time from injury to consultation ranged from 2.5 to 19.0 hours，with an average of(9.60±2.53)hours.The control group was treated with the elastic intramedullary nail fixation.There was a total of 32 cases，including 23 males and 9 females，ranging from 7 to 14 in age，with an average(10.68±3.82)years old；including 11 cases on the left side and 21 cases on the right side.The time from injury to consultation ranged from 2.0 to 19.0 hours，with an average of(9.86±2.38)hours.Then the two groups of patients were compared to estimate the curative effect on fracture healing time，treatment cost and the days of hospitalization and complications，which are based on Anderson score. Results All fractures healed within 9 to 14 weeks，with an average of 12.15 weeks.The difference in healing time between the two groups was not statistically significant(P＞0.05).The treatment cost(2 232.61±81.75)yuan in the observation group was lower than that in the control group(15 730.25±835.52)yuan，the difference was statistically significant(P＜0.05)，the length of stay(6.39±2.43)d was shorter than that in the control group(13.16±2.78)d，and the incidence of complications(16.67%)was lower than that in the control group(53.13%)，the difference was statistically significant(P＜0.05).In comparison of Anderson scores between the two groups，the excellent and good rate was 88.89% in the observation group and 90.63% in the control group.There was no statistically significant difference between the two groups(P＞0.05).Conclusion Manual reduction splint external fixation and elastic intramedullary nail internal fixation can both achieve satisfactory results for forearm fracture.However，manual reduction splint external fixation has the advantages of less trauma，simpler technique，lower cost，shorter hospital stay and fewer complications，which are worthy of recommendation.

Key words： children forearm fracture manual reduction splint elastic intramedullary nail fix

通讯作者: 郭跃明

作者简介: 柯华荣(1990－ )，男，研究生在读，广州中医药大学附属佛山市中医院小儿骨科，528000。

引用本文:

柯华荣 1，2,郭跃明 1*,卢凤珊 1，马洪 1. 手法复位配合夹板外固定治疗儿童前臂骨折的疗效观察[J]. 实用骨科杂志, 2020, 26(2): 97-102.
Ke Huarong 1，2,Guo Yueming 1，Lu Fengshan 1，et al. Efficacy of Manipulation Reduction and Splint External Fixation in the Treatment of Forearm Fractures in Children. sygkzz, 2020, 26(2): 97-102.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2020/V26/I2/97

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