儿童桡骨远端不稳定性骨折手术治疗结果的比较分析
- 作者: Vissarionov S.V.1, Bolshakov G.A.2
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隶属关系:
- H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
- Irkutsk Municipal Pediatric Clinical Hospital
- 期: 卷 13, 编号 3 (2025)
- 页面: 237-246
- 栏目: Clinical studies
- URL: https://medbiosci.ru/turner/article/view/349945
- DOI: https://doi.org/10.17816/PTORS676873
- EDN: https://elibrary.ru/CWPTIQ
- ID: 349945
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论证。桡骨远端骨折在儿童肌肉骨骼损伤的整体构成中仍然占据领先位置。这些患者治疗效果不佳,不仅导致需要再次手术,而且伴随上肢功能活动受限。鉴于上述情况,针对儿童桡骨远端不稳定性骨折,寻找能够最大程度降低并发症风险并改善康复效果的新型有效外科治疗方法,仍具有重要的现实意义和价值。
目的。对比两种不同方法在儿童桡骨远端不稳定性骨折手术治疗中的疗效。
方法。共完成83例儿童桡骨远端不稳定性骨折的手术治疗。第1组患者(n=52)接受了采用改良顺行弯曲克氏针髓内固定方法的手术(发明专利号2835501,2025年1月20日);第2组患者(n=31)接受了采用逆行克氏针髓内固定方法的手术。在术后1、3、6和12个月对治疗结果进行评估,评估内容包括手术并发症、邻近关节挛缩、手术时间及骨折愈合速度。统计学分析采用Mann–Whitney检验、Yates校正的χ2检验和Fisher精确检验。
结果。结果显示,与接受改良顺行植入金属内固定方式手术的患儿相比,接受逆行克氏针髓内固定术的患儿在术后并发症的发生率和严重程度方面均更高,临床结局也较不理想。在技术操作特点方面,作者提出的改良手术方法与经典方法相比并不更复杂,这一点通过两组手术时间无显著差异得到了证实。在接受改良方法治疗的患儿中显示出更高的远期功能学结果。这为将该方法视为不仅具有竞争力,而且更具优选性的治疗方式提供了依据。
结论。研究结果表明,采用所提出的改良方法治疗儿童桡骨远端不稳定性骨折具有使用的合理性,其目的在于降低术后并发症风险并改善康复治疗效果。
作者简介
Sergei V. Vissarionov
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN 代码: 7125-4930
MD, Dr. Sci. (Medicine), Professor, Corresponding Member of RAS
俄罗斯联邦, Saint PetersburgGleb A. Bolshakov
Irkutsk Municipal Pediatric Clinical Hospital
编辑信件的主要联系方式.
Email: bolgleb@mail.ru
ORCID iD: 0000-0002-7325-5528
SPIN 代码: 8571-4512
MD
俄罗斯联邦, Irkutsk参考
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