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目的:探讨经皮撬拨复位术治疗儿童软组织损伤严重的胫骨干横行骨折的临床意义。方法:利用自制的撬拨复位工具,在C臂机透视下,对儿童横行胫骨干骨折进行经皮撬拨复位,复位后进行石膏托外固定,统计手术时间、出血量,通过定期随访观察骨折愈合情况及相关并发症。结果:所有儿童胫骨干横行骨折都可通过自制的撬拨复位工具达到解剖复位或接近解剖复位,除1例有浅表感染,经伤口换药后愈合,其余患者未出现软组织感染、骨髓炎、坏死,术中出血量少,骨折均一期愈合。结论:经皮撬拨复位术是一种微创复位方式,对于儿童局部软组织条件差的难复性胫骨干骨折可达到损伤小、不损伤骨膜、避免伤口感染、复位后相对稳定、可早期功能锻炼等优点,是一种较好的临床复位方式。
Objective: To investigate the clinical significance of percutaneous poking reduction in the treatment of severe tibial shaft transverse fractures in children with soft tissue injuries. Methods: The self-made poking reduction tool was used to perform percutaneous poking reduction of pediatric transverse tibial shaft fractures under C-arm fluoroscopy. External fixation of gypsum plaster was performed after reduction. The operation time and amount of bleeding were counted. Fractures were observed by regular follow-up Healing and related complications. Results: All pediatric tibial shaft transverse fractures can be achieved by the self-made poking reduction tool to achieve anatomical reduction or near anatomic reduction. In addition to one case of superficial infection, the wound healed after dressing change. The remaining patients did not have soft tissue infection, osteomyelitis, Necrosis, intraoperative blood loss, fractures were healed. Conclusion: Percutaneous poking reduction is a minimally invasive reduction, which can reduce the damage of the hard-tibial shaft fractures in children with poor local soft tissue conditions, without damaging the periosteum and avoiding wound infection. It is relatively stable after reset and can be used for early function Exercise, etc., is a better way of clinical reset.