Volume 19 Issue 9
Sep.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(9): 1459-1462
LI Yang, XIE Kang, YUAN Yi, SUN Jun. Treatment of Judet Ⅳ type radial neck fracture in young children with Kirschner wire percutaneous leverage reduction and elastic intramedullary nail fixation under elbow arthrography[J]. Chinese Journal of General Practice, 2021, 19(9): 1459-1462. doi: 10.16766/j.cnki.issn.1674-4152.002085
Citation: LI Yang, XIE Kang, YUAN Yi, SUN Jun. Treatment of Judet Ⅳ type radial neck fracture in young children with Kirschner wire percutaneous leverage reduction and elastic intramedullary nail fixation under elbow arthrography[J]. Chinese Journal of General Practice, 2021, 19(9): 1459-1462. doi: 10.16766/j.cnki.issn.1674-4152.002085
shu

Treatment of Judet Ⅳ type radial neck fracture in young children with Kirschner wire percutaneous leverage reduction and elastic intramedullary nail fixation under elbow arthrography

doi: 10.16766/j.cnki.issn.1674-4152.002085

  • Department of Orthopedics, Anhui Provincial Children's Hospital, Provincial Children's Hospital of Anhui Medical University, Hefei, Anhui 230051, China

Funds:

 U19A2057

 2020xkj254

 19rtyy001

  • Received Date: 2021-04-12
    Available Online: 2022-02-15
    Abstract
  •   Objective  To investigate the application of elastic intramedullary nail internal fixation after Kirschner wire (K-wire) percutaneous leverage reduction with elbow arthrography in the treatment of Judet Ⅳ type radial neck fracture in young children.   Methods  A total of 29 children (including 11 males and 18 females, aged 3 years and 3 months to 6 years and 11 months) in the Department of Orthopedics of Anhui Children's Hospital from September 2017 to September 2020 were selected. All children suffered Judet Ⅳ type radial neck fracture within one week after trauma. All patients underwent surgery under general anaesthesia after hospitalisation. The contrast agent was 1 mL iohexol, mixed with normal saline in a ratio of 1∶ 1 and injected into the elbow joint in the posterior space of the elbow. C-arm fluoroscopy showed the cartilage and epiphysis at the broken end of the fracture, which had not been developed before. The broken end of the fracture was reduced by K-wire pry, and the fracture was fixed by retrograde penetration of elastic intramedullary nail from the distal end of the radius. The functional position of the elbow was fixed in plaster for four weeks after surgery.   Results  According to Metaizeau's revision standard, 24 cases were excellent, 3 cases were good, and 2 cases were fair. The 29 children were followed up for 6-36 months in the outpatient department. According to Metaizeau's curative effect standard, 26 cases were excellent, 2 cases were good, and 1 case was fair. The excellent and good rate was 96.5%. Postoperative follow-up radiographs showed no fracture redisplacement and necrotic absorption of the radial head. No complications such as fracture nonunion, myositis ossificans, radial nerve injury and elbow joint dysfunction were observed in all cases.   Conclusion  Elbow arthrography can clearly show the cartilage and epiphysis at the broken end of the fracture without development in the treatment of the Judet Ⅳ type of radial neck fracture in young children. The trauma of reduction by K-wire prying is small, and the internal fixation by elastic intramedullary nail is firm. This method is especially effective for the treatment of Judet Ⅳ type radial neck fracture in young children, and the long-term joint function recovery is good.

     

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    • References(22)
  • [1]
    张涛, 郭源, 吕学敏, 等. 2009—2016年28867例儿童肘部骨折的调查研究[J]. 骨科临床与研究杂志, 2018, 3(4): 218-224. https://www.cnki.com.cn/Article/CJFDTOTAL-GKLC201804008.htm
    [2]
    刘玉昌, 王磊. 儿童桡骨颈骨折治疗技术及研究现状[J]. 实用骨科杂志, 2017, 23(6): 525-529. https://www.cnki.com.cn/Article/CJFDTOTAL-SGKZ201706014.htm
    [3]
    王小波, 胡燕. 儿童肘关节损伤诊治失误原因分析[J]. 中国伤残医学, 2018, 26(8): 97-98.
    [4]
    ASHISH M, NARANG, ANUJA A, et al. Management of severely displaced radial neck fractures in children: A systematic review and meta-analysis of outcomes[J]. Indian J Orthop, 2020, 54(1): 60-68. doi: 10.1007/s43465-019-00032-2
    [5]
    吴声忠, 林廉洋, 周开亮, 等. 关节造影下微创治疗低龄儿童桡骨颈骨折21例[J]. 中国中医骨伤科杂志, 2020, 28(7): 75-77. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZG202007020.htm
    [6]
    SHABTAI L, ARKADER A. Percutaneous reduction of displaced radial neck fractures achieves better results compared with fractures treated by open reduction[J]. J Pediatr Orthop, 2016, 36: S63-S66. doi: 10.1097/BPO.0000000000000763
    [7]
    蔡英富, 崔顺平, 秦立亭. 双头加压螺钉及微型锁定接骨板在桡骨小头骨折内固定中的应用[J]. 海南医学, 2019, 30(19): 2507-2510. doi: 10.3969/j.issn.1003-6350.2019.19.018
    [8]
    杜香平, 余丽蓉, 熊志刚, 等. 克氏针经皮撬拨复位联合Métaizeau法治疗儿童Judet Ⅳ型桡骨颈骨折[J]. 中华手外科杂志, 2018, 34(1): 10-12. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG201602009.htm
    [9]
    林红明, 马一平, 胡成挺, 等. 改良Metaizeau法治疗JudetⅢ型或Ⅳ型儿童桡骨颈骨折[J]. 中国骨伤, 2018, 31(9): 790-793. doi: 10.3969/j.issn.1003-0034.2018.09.002
    [10]
    邓闽军, 闵继康, 徐旭纯, 等. 微创治疗儿童桡骨颈骨折[J]. 浙江临床医学, 2018, 20(4): 657-658. https://cdmd.cnki.com.cn/Article/CDMD-10285-1016221876.htm
    [11]
    孙祥水, 侯华成, 汪飞, 等. 经皮血管钳捋拨复位弹性髓内针固定治疗儿童桡骨颈O'Brien Ⅱ、Ⅲ型骨折[J]. 中华小儿外科杂志, 2019, 40(2): 152-157.
    [12]
    杨大兴, 单延具, 张琰, 等. 弹性髓内钉与克氏针固定治疗儿童桡骨颈骨折的临床对比[J]. 实用骨科杂志, 2019, 25(11): 961-964. https://www.cnki.com.cn/Article/CJFDTOTAL-SGKZ201911001.htm
    [13]
    郭月超, 张玉舰, 王哲, 等. 弹性髓内针治疗儿童桡骨颈骨折的方案选择[J]. 河北医药, 2019, 41(9): 1391-1393, 1397. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYZ201909028.htm
    [14]
    朱佳, 夏先强, 赵诗铁, 等. 四肢骨折患者术后手术部位感染发生率及预测模型的构建[J]. 海南医学, 2021, 32(4): 456-459. https://www.cnki.com.cn/Article/CJFDTOTAL-HAIN202104013.htm
    [15]
    王林, 陈梦婕, 王一臣, 等. 经皮撬拨辅助弹性髓内钉治疗小儿桡骨颈骨折的疗效研究[J]. 实用骨科杂志, 2019, 25(9): 830-832. https://www.cnki.com.cn/Article/CJFDTOTAL-SGKZ201909017.htm
    [16]
    沈先涛, 陈小亮, 李雄涛, 等. B型超声引导经皮克氏针撬拨治疗儿童桡骨颈骨折[J]. 中华小儿外科杂志, 2015, 36(5): 363-367.
    [17]
    姜海, 李敏, 吴永涛, 等. 术中肘关节造影辅助经皮撬拨复位克氏针内固定治疗儿童桡骨颈骨折[J]. 中国骨与关节杂志, 2017, 6(7): 517-521. https://www.cnki.com.cn/Article/CJFDTOTAL-GZGL201707012.htm
    [18]
    姜海, 吴永涛, 汪兵, 等. 术中肘关节造影辅助治疗低龄儿童桡骨颈骨折[J]. 实用骨科杂志, 2019, 25(3): 197-200, 204. https://www.cnki.com.cn/Article/CJFDTOTAL-SGKZ201903002.htm
    [19]
    袁毅, 金瑞, 姚杰, 等. 儿童闭合性Ⅲ型肱骨髁上骨折并桡神经损伤的疗效观察[J]. 中华全科医学, 2020, 18(2): 185-187, 276. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202002006.htm
    [20]
    胡成挺, 马一平. 弹性钉闭合复位内固定治疗儿童桡骨颈骨折[J]. 浙江临床医学, 2017, 19(3): 456-457. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZG202008014.htm
    [21]
    易申德, 蔡军, 邹筠. 闭合复位弹性髓内钉固定和经皮克氏针撬拨复位固定治疗儿童桡骨颈骨折的疗效比较[J]. 实用临床医药杂志, 2021, 25(4): 77-80. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202104020.htm
    [22]
    陈星光, 刘珏, 王晓东, 等. 两种术式治疗儿童桡骨颈骨折疗效的Meta分析[J]. 中华小儿外科杂志, 2017, 38(5): 349-355.
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