| 周治国,雷渊学,李俊,等.超声引导下闭合复位联合外固定架治疗青少年及儿童肱骨近端骨折.骨科,2021,12(5): 435-439. |
| 超声引导下闭合复位联合外固定架治疗青少年及儿童肱骨近端骨折 |
| Treatment of Adolescent Proximal Humeral Fractures Using Ultrasound-Guided Closed Reduction and External Fixation |
| 投稿时间：2021-03-17 |
| DOI：10.3969/j.issn.1674-8573.2021.05.009 |
| 中文关键词: 肱骨近端骨折 青少年 闭合复位 超声引导 |
| 英文关键词: Proximal humeral fracture Adolescent Reduction Ultrasound-guided |
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| 中文摘要: |
| 目的 探讨超声引导下闭合复位联合外固定架治疗青少年及儿童肱骨近端骨折的临床疗效。方法 回顾性分析2019年1月至2020年12月我院收治的38例移位明显的肱骨近端骨折病人的临床资料，其中男25例，女13例，年龄为6~17岁，平均年龄为10.3岁。手术方式均采用超声引导下骨折闭合复位联合外固定架。全程使用超声进行监控，术前明确骨折情况，术中引导下复位并维持位置安装组合外固定架，固定完成后再次进行超声检查骨折复位质量，并行“C”型臂X线机透视验证复位状态。结果 36例病人闭合复位成功，2例病人术中复位困难后转开放复位，闭合复位成功率为94.7%。所有病人均无神经血管损伤等相关并发症。闭合复位成功的36例病人，术后X线片复查，骨折对位对线良好，无Schanz针误伤骺板的发生。术后3个月随访，拆除外固定架，复查X线片，骨折愈合良好，无肱骨近端畸形愈合，术后肩关节功能良好。骨折愈合时间为8~12周，平均为10.5周。结论 超声引导下闭合复位联合外固定架可以有效提高青少年及儿童肱骨近端骨折闭合复位成功率，减少病人辐射及不良结局，值得推广。 |
| 英文摘要: |
| Objective To evaluate the clinical effect of ultrasound-guided closed reduction combined with external fixator in the treatment of proximal humeral fractures in adolescents and children. Methods Totally, 38 cases of displaced proximal humeral fractures in our hospital from January 2019 to December 2020 were retrospectively analyzed, including 25 boys and 13 girls, with age of 6-17 years old (mean age 10.3 years old). All cases were treated with ultrasound-guided closed reduction and external fixation. The whole process was monitored by ultrasound. The fracture condition was confirmed before operation. The combined external fixator was installed under the guidance of intraoperative reduction and maintaining position. After fixation, the quality of fracture reduction was detected by ultrasound again, and the reduction status was verified by C-arm fluoroscopy. Results All operations in 36 patients were successful in closed reduction, 2 patients were converted to open reduction, and the success rate of closed reduction was 94.7%. There were no complications related to the plexus and artery injury in all patients. In 36 patients with successful closed reduction, postoperative X-ray film reexamination showed that the fracture alignment was good, and there was no injury of epiphyseal plate by Schanz needle. After 3 months follow-up, the external fixator was removed and X-ray film was reexamined. The fracture healing time was 8-12 weeks, with an average of 10.5 weeks. All fractures healed well without malunion of proximal humerus and the shoulder function was maintained well. Conclusion Ultrasound-guided closed reduction combined with external fixator can effectively improve the success rate of closed reduction of proximal humeral fractures in adolescents and children, reducing patients’ radiation exposure and operation complications, which is worthy of popularization. |
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