两种外固定方法治疗儿童尺桡骨干骨折的临床对比研究

目的 探讨儿童稳定性尺桡骨干双骨折的最佳治疗策略。方法 对2009年10月～2013年8月在我院确诊的尺桡骨干双骨折患儿，行手法复位后，对稳定性骨折，随机采用前臂夹板联合长臂石膏或单纯前臂夹板外固定，48例患者采用夹板联合石膏外固定，60例患者采用单纯夹板外固定。术后定期拍摄正侧位X光片，术后3、6个月测量肘、腕关节活动度，及6个月进行Grace-Eversmann前臂骨折疗效评价。结果 随访1年，所有患者都得到临床愈合，单纯夹板组在3个月时肘关节活动度明显优于夹板联合石膏组(P<0.05)，6个月时两组肘关节活动度无显著差异，术后3、6个月时两组腕关节活动均无显著性差异；6个月时两组Grace-Eversmann前臂双骨折疗效评价优良率分别为95.8%（联合固定组）和95.0%( 单纯夹板组)，两组间无统计学差异（P>0.05）。结论 对稳定性尺桡骨干双骨折，单纯夹板固定可收到良好的治疗效果，无需额外加石膏联合固定。

Clinical comparative study of two kinds of external fixation on the treatment of ulnar and radial shaft fractures in children

ABSTRCT Objective To explore the optimal treatment strategy on the Stable fracture of the radius and ulna in children. Methods From October 2009 to August 2013 in our hospital, the patients with fractures of ulnar and radial in children were treated with manipulative reduction. The Stable fractures were divided randomly into two groups. They were respectively fixed with forearm splint external fixation combined with long arm plaster (group A, 48cases) and forearm splint external fixation (group B, 60 cases). During the follow- up period, range of motion of the elbow and wrist was measured at 3,6 month, and radiological assessment was obtained at 1,3,6 week and 6 month, and Grace-Eversmann therapeutic evaluation was obtained to assess the fracture union and function at 6 month Postoperatively. Result All the patients resulted in clinical healing. Elbow motion treaded with splint external fixation is obviously better than that of splint external fixation combined with long arm plaster, while there were no statistically significant differences at 6 month. There were no statistically significant differences on range of motion of the wrist at either 3 month or 6 month. The total effective rate of the patients was 95.8%(group A) and 95.0%(group B) respectively, according to Grace-Eversmann therapeutic evaluation of the fracture of ulna and radius at 6 month, a difference that was not statistically significant. Conclusion Forearm splint external fixation alone appears to be an effective means of maintaining alignment to bone healing during the stable fracture of ulna and radius, without extra long arm plaster.