本文選題：小兒尺橈骨骨折 + 保守治療�。� 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:比較三種不同的方法治療小兒前臂雙骨折的臨床效果,為臨床上小兒前臂雙骨折治療方法的選擇提供參考。方法:前瞻性分析2012年9月-2017年1月甘肅省人民醫(yī)院骨科門診收治的48例尺橈骨骨折患兒的臨床資料,以尺橈骨中段骨折為主,根據(jù)隨機(jī)對照和盲法原則隨機(jī)分為三組;A組:男9例,女7例,平均年齡(6.7±1.3)歲,采用保守治療;B組:男9例,女7例,平均年齡(6.9±1.1)歲,采用彈性髓內(nèi)釘進(jìn)行治療;C組:男8例,女8例,平均年齡(7.0±0.9)歲,采用鋼板螺釘進(jìn)行治療。結(jié)果:A組患兒的骨折愈合時間為49.17±4.24天,治愈率為62.5%,不愈合率為6.2%,Anderson前臂骨折功能評分優(yōu)良者占75%;并發(fā)癥發(fā)生率為18.7%;B組患兒的骨折愈合時間為(35.01±3.29)d,治愈率為87.5%,不愈合率為0,Anderson前臂骨折功能評分優(yōu)良者占93.7%;手術(shù)時間及術(shù)中出血量分別為(36.93±4.24)min和(14.15±2.86)m L;并發(fā)癥發(fā)生率為6.25%;C組患兒的骨折愈合時間為(45.12±5.49)d,愈合率為62.5%,不愈合率為12.5%,Anderson前臂骨折功能評分優(yōu)良者占87.5%;手術(shù)時間及術(shù)中出血量分別為(80.52±6.65)min和(154.31±16.86)m L A、B、C組兩兩相比,A與B及B與C間骨折愈合時間、愈合率、Anderson前臂骨折功能評分、并發(fā)癥發(fā)生率均存在顯著差異(P0.05),相比A和C,B組臨床療效更好。A與C組間骨折愈合時間、治愈率、Anderson前臂骨折功能評分均無統(tǒng)計學(xué)差異(P0.05);B與C兩種手術(shù)治療方法相比較,B組手術(shù)時間和術(shù)中出血量顯著低于C組(P0.01)。結(jié)論:保守治療、彈性髓內(nèi)釘治療及鋼板螺釘治療均能有效治療尺橈骨骨折,然而與鋼板螺釘治療及保守治療相比較而言,彈性髓內(nèi)釘治療具有切口損傷小、手術(shù)時間短、閉合復(fù)位成功率高、骨折愈合速度較快、再次拆除固定時損傷較小等優(yōu)勢。相對于保守治療和彈性髓內(nèi)釘手術(shù)治療而言,骨折愈合時間短,治愈率高。因此,三種治療方法中,彈性髓內(nèi)釘臨床治療效果更好,并發(fā)癥更少。
[Abstract]:Objective: to compare the clinical effects of three different methods for the treatment of double forearm fractures in children. Methods: the clinical data of 48 children with ulnar and radial fractures treated in Department of Orthopaedics of Gansu Provincial people's Hospital from September 2012 to January 2017 were analyzed prospectively. According to the principle of random control and blind method, three groups were randomly divided into three groups: male 9 cases, female 7 cases, mean age of 6.7 鹵1.3 years old. Conservative treatment group B: male 9 cases, female 7 cases, mean age 6.9 鹵1.1 years old, treated with elastic intramedullary nail in group C: male 8 cases. Female 8 cases, mean age was 7.0 鹵0.9 years old, treated with plate and screw. Results the time of fracture healing in group A was 49.17 鹵4.24 days. The cure rate was 62.5, the nonunion rate was 6.2Anderson forearm fracture, 75 patients had excellent functional score of forearm fracture, the complication rate was 18.7B, the healing time was 35.01 鹵3.29 days, the cure rate was 87.5, and the nonunion rate was 0.Anderson forearm fracture functional score. The time and volume of intraoperative bleeding were 36.93 鹵4.24)min and 14.15 鹵2.86mLrespectively, the incidence of complications in group C was 6.25C, the healing time was 45.12 鹵5.49nd, the healing rate was 62.5 and the non-union rate was 12.5Anderson 's forearm fracture functional score was 87.5mm; the operative time and intraoperative bleeding score were 87.5; The healing time of fracture between group A and B and between group B and C were 80.52 鹵6.65)min and 154.31 鹵16.86mL / L respectively. There were significant differences in the healing rate of Anderson's forearm fracture functional score and the incidence of complications (P 0.05). The healing time between group A and group C was better than that of group A and group C. There was no significant difference in the functional score of Anderson's forearm fracture between group B and group C. the operative time and blood loss in group B were significantly lower than those in group C (P 0.01). Conclusion: conservative treatment, elastic intramedullary nail treatment and plate and screw treatment can effectively treat ulnar and radial fractures, but compared with plate and screw treatment and conservative treatment, elastic intramedullary nail treatment has less incision injury and shorter operation time. The closed reduction rate is high, the fracture healing speed is faster, and the injury is less when the fixation is removed again. Compared with conservative treatment and elastic intramedullary nail surgery, fracture healing time is short and cure rate is high. Therefore, elastic intramedullary nail has better clinical effect and fewer complications.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R726.8

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