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目的总结采用手术开放复位、克氏针内固定治疗小儿MasonⅡ型桡骨头颈骨折的临床疗效。方法2007年9月-2009年6月,采用手术开放复位、克氏针内固定治疗小儿桡骨头颈骨折17例。其中男11例,女6例;年龄4～11岁,平均8.5岁。左侧5例,右侧12例。均为跌伤所致。骨折按Mason分型均为Ⅱ型。伴桡神经深支损伤2例。伤后至手术时间4h～5d。结果术后患儿伤口均Ⅰ期愈合。按照Métaizeau标准评定手术复位情况,良好15例,较好2例;均达到解剖复位或接近解剖复位。17例均获随访,随访时间6～25个月,平均14个月。2例桡神经损伤患儿术后6个月功能恢复正常。术后无关节感染、神经损伤等并发症。术后复查X线片示骨折均获骨性愈合,愈合时间2.0～3.5个月,平均3.0个月。术后6个月采用Broberg等肘关节功能评分法评定肘关节功能,获优11例,良4例,可2例,优良率88.2%。结论手术开放复位、克氏针内固定治疗小儿MasonⅡ型桡骨头颈骨折疗效可靠,功能恢复好,并发症少。
Objective To summarize the clinical effects of open reduction and Kirschner wire fixation in the treatment of Mason type Ⅱ radial head and neck fracture in children. Methods From September 2007 to June 2009, 17 cases of pediatric radial head and neck fracture were treated with open reduction and Kirschner wire fixation. Including 11 males and 6 females; aged 4 to 11 years, mean 8.5 years. Left in 5 cases, right in 12 cases. Caused by falls. According to Mason type fractures are type Ⅱ. Radial nerve deep branch injury in 2 cases. Injury to surgery time 4h ~ 5d. Results All the wounds were healed first. According to the criteria of Métaizeau, the surgical reduction was evaluated. There were 15 patients in good condition and 2 patients in good condition. Both of them achieved anatomic reduction or close to anatomic reduction. All 17 patients were followed up for 6 ~ 25 months with an average of 14 months. Two cases of radial nerve injury in children 6 months after the function returned to normal. No joint infection, nerve injury and other complications. Postoperative X-ray showed fractures were bone healing, healing time 2.0 to 3.5 months, an average of 3.0 months. Six months after operation, Broberg and other elbow joint function scoring method was used to evaluate the elbow joint function. Eleven patients were excellent, 4 good and 2 fair. The excellent and good rate was 88.2%. Conclusion Operative open reduction and Kirschner wire internal fixation for the treatment of pediatric Mason type Ⅱ radial head and neck fracture are reliable and reliable, with good functional recovery and few complications.