内固定与非内固定在尺骨截骨治疗儿童陈旧性孟氏骨折后的疗效对比分析
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南京医科大学附属儿童医院

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Comparative analysis of the effect of internal fixation and non-internal fixation in the treatment of old Monteggia fractures in children after ulnar osteotomy
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1.Children&2.amp;3.#39;4.&5.s Hospital affiliated to Nanjing Medical University

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    摘要:

    对比分析内固定与非内固定在尺骨截骨治疗儿童陈旧性孟氏骨折后的疗效。方法 选取2015年6月—2021年6月本院收治的79例儿童陈旧性孟氏骨折患者为研究对象,根据手术方式分为内固定组(n=40,尺骨截骨后内固定治疗)和非内固定组(n=39,尺骨截骨后非内固定治疗),记录两组手术时间、出血量,术后并发症发生率,Nakamura优良率,前臂旋前、旋后、屈伸活动度(ROM),Mayo评分,骨折愈合时间。结果 非内固定组治疗用时、出血量、骨折愈合时间低于内固定组(P<0.05);末次随访时两组前臂旋前、旋后、屈伸ROM及Mayo评分均较术前提高(P<0.05),但两组间比较差异无统计学意义(P>0.05);术后两组并发症发生率、Nakamura优良率比较,差异无统计学意义(P>0.05)。结论 尺骨截骨内固定与非内固定治疗儿童陈旧性孟氏骨折,并发症少,均可改善患儿前臂ROM及肘关节功能,且疗效显著。非内固定组治疗用时短、出血量少、骨折愈合时间短。

    Abstract:

    To compare the effects of internal fixation and non-internal fixation in the treatment of old Monteggia fractures in children after ulnar osteotomy.Methods A total of 79 children with old Monteggia fractures admitted to our hospital from June 2015 to June 2021 were selected as the research objects, and were divided into internal fixation groups according to different surgical methods (n=40, internal fixation after ulnar osteotomy) And non-internal fixation group (n=39, non-internal fixation treatment after ulnar osteotomy), record the operation time, blood loss, postoperative complication rate, Nakamura good and good rate, forearm pronation, supination, flexion and extension activity in the two groups (ROM), Mayo score, fracture healing time.Results The treatment time, blood loss and fracture healing time of the non-internal fixation group were lower than those of the internal fixation group (P<0.05),at the last follow-up, the scores of forearm pronation, supination, flexion and extension ROM and Mayo scores of the two groups were improved compared with those before operation (P<0.05), but there was no significant difference between the two groups (P>0.05); There was no significant difference in the excellent and good rate of Nakamura (P>0.05).Conclusion Ulnar osteotomy, internal fixation and non-internal fixation for the treatment of children's old Monteggia fractures, with fewer complications, can improve children's forearm ROM and elbow joint function, and the effect is significant. The treatment time of the non-internal fixation group was short, the amount of bleeding was less, and the fracture healing time was short.

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  • 收稿日期:2021-07-30
  • 最后修改日期:2021-11-05
  • 录用日期:2022-02-25
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