儿童尺桡骨远端骨折的治疗选择.docVIP

儿童尺桡骨远端骨折的治疗选择 【摘要】 目的 评价不同治疗方法治疗儿童尺桡骨远端骨折的原则、可行性及。 方法2007-2010年收治尺桡骨远端骨折110例其中桡骨远端骨骺骨折30例（A组），桡骨远端干骺端骨折30例（B组），桡骨干骺端骨折伴尺骨远端骨折50例（C组）。根据Bohm ER，按Berton愈后评价标准结果 A组30例，有1例石膏固定一周后骨折发生移位，重新塑形石膏。B组30例，有1例石膏固定两周后骨折发生移位，后行二次复位克氏针固定。C组50例，有2例发生再骨折，均行二次切开复位克氏针内固定。结论 儿童尺桡骨远端骨折常见，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。 【关键词】 儿童；尺桡骨远端骨折；个体化治疗 The treatment of distal forearm fracture in children 【Abstract】 Objective Evaluation of different treatment methods for distal forearm fracture in children the principles, the feasibility and long-term results. Methods One hundred and ten patients with fracture of distal forearm were ed from 2007-2010. Of 110 casess, 30 cases are distal radial physeal fractures (group A), 30 cases are distal metaphyseal fractures (group B), 50 cases are distal radial metaphyseal fractures and ulna distal fracture (group C). Bohm provide two criterias, one is the acceptable reduction, another is whether remanipulation required for loss of reduction. All cases were followed-up 2-5 year by Berton criteria . Results In group A, 1 case occurred redisplacement one week after closed reduction, re-moulding plaster. In group B, 1 case occurred redisplacement two week after closed reduction, remanipulation and Kirschner wiring. In group C, 2 cases occurred refracture, open reduction and fixed by Kirschner wires. Conclusions Fractures of the distal forearm are extremely common, they remodel satisfactorily with excellent functional recovery, but different types of fracture treatment varies, advocate in dividualized treatment. 【Key Words】 children; distal forearm fracture; individual treatment 尺桡骨远端骨折在儿童很常见，随着年龄增大，活动量增大，体重增加，骨折发生的危险因素增大。儿童尺桡骨远端骨折分为隆凸骨折、青枝骨折、干骺端骨折、骨骺骨折和盖氏骨折，其中骨骺骨折常见是Salter-Harris I 型和II型骨折[1]。盖氏Galeazzi）骨折伴有下尺桡关节的脱位，是一特殊类型的尺骨远端骨折。骨折通常与关节活动方向一致，塑形能力强，愈后好，但需综合考虑患儿年龄、尺桡骨远端的生物学特点、骨折的受伤机制、骨折类型、稳定性、软组织及神经损伤情况，提倡个体化治疗[2,3]。本文重点探讨桡骨远端骨骺骨折、干骺端骨折，桡骨干骺端骨折伴尺骨远端骨折的治疗方法及特点。 资料和方法 一、一般资料 2007-2010年收治尺桡骨远端骨折完整病例资料110例其中桡骨远端骨骺骨折30例（A组），桡骨远端干骺端骨折30例（B组），桡骨干