摘要
目的探讨磁共振联合关节造影在儿童JakobⅡ型肱骨外髁骨折诊疗中的作用。方法回顾性分析2018年2月至2020年2月行手术治疗的JakobⅡ型肱骨外髁骨折儿童28例,其中男15例,女13例,年龄2~8岁,平均(4.3±2.1)岁。患儿术前均行肘关节磁共振检查。观察组14例,术中先采用关节造影检查骨折端移位情况,行闭合复位克氏针固定,再用C臂机透视确定复位程度和克氏针位置;对照组14例,均行肱骨外髁骨折切开复位克氏针固定。比较两组的临床效果及围术期指标。结果与对照组比较,观察组手术时间明显缩短,术中出血量明显减少(P<0.05),骨折愈合时间无统计学差异(P>0.05)。根据Broberg和Morrey评分标准,观察组肘关节功能优12例,良1例,中1例,优良率为92.9%,对照组优11例,良1例,中2例,优良率为85.7%,两组术后肘关节功能比较无统计学差异(P>0.05)。观察组和对照组的术后并发症发生率分别为14.3%和21.4%,组间比较无统计学差异(P>0.05)。结论磁共振联合关节造影引导下闭合复位克氏针儿童JakobⅡ型肱骨外髁骨折,手术创伤小,出血量少,并发症发生率低,值得临床推广应用。
Objective To explore the role of MRI combined with arthrography in the diagnosis and treatment of Jakob type 2 humeral condyle fractures in children.Methods A retrospective analysis was conducted on 28 children with Jakob type 2 lateral humeral condyle fractures from February 2018 to February 2020,including 15 males and 13 females,aged 2 to 8 years,with an average of(4.3±2.1)years.All patients underwent MRI before surgery.In the observation group consisted of 14 cases,intraoperative elbow arthrography was first used to determine the displacement of fracture ends,followed by closed reduction and Kirschner wire fixation.In the control group consisted of 14 cases,open reduction and Kirschner wire fixation was done.The clinical outcomes and perioperative indicators between the two groups were compared.Results The observation group showed a significant reduction in surgical time and intraoperative bleeding(P<0.05),but there was no significant difference in fracture healing time between the two groups(P>0.05).According to Broberg and Morrey criteria,the observation group had 12 cases of excellent elbow joint function,1 case of good,and 1 case of moderate,with an excellent and good rate of 92.9%.The control group had 11 cases of excellent,1 case of good,and 2 cases of moderate,with an excellent and good rate of 85.7%.There was no significant difference in elbow joint function between the two groups(P>0.05).The incidence of postoperative complications in the observation group and the control group was 14.3%and 21.4%respectively,with no significant difference(P>0.05).Conclusion Under the guidance of MRI combined with arthrography,closed reduction and Kirschner wire fixation of Jakob type 2 humeral condyle fracture in children is recommended,with minimal surgical trauma,minimal bleeding,and low incidence of complications.It is worthy of clinical promotion and application.
作者
戴海波
刘佳
龙扬
文跃军
DAI Haibo;LIU Jia;LONG Yang;WEN Yuejun(Department of Orthopedics,Wangcheng District People's Hospital,Changsha 410299,Hunan,China)
出处
《中国现代手术学杂志》
2024年第3期182-186,共5页
Chinese Journal of Modern Operative Surgery
关键词
磁共振检查
关节造影
肱骨骨折
闭合复位
切开复位
克氏针
magnetic resonance imaging
arthrography
humeral fractures
closed reduction
open reduction
Kirschner wire
