病灶清除植骨合克氏针内固定对儿童肱骨近端病理性骨折疗效观察

目的:探讨病灶清除植骨联合克氏针内固定治疗儿童肱骨近端病理性骨折临床疗效。方法:回顾性分析2015年1月~2017年1月收治的行病灶清除植骨联合克氏针内固定治疗的22例肱骨近端病理性骨折患儿临床资料。观察术后并发症、影像学检查结果、骨折愈合时间及临床疗效。结果:21例患儿骨折愈合良好,平均9周骨折愈合,无骨折延迟愈合或不愈合及针道感染等发生;1例因术后过早、过度负重活动导致克氏针松动及骨折断端成角,再次手术后行Samfiento支具固定,术后12周骨折愈合;按照Conmanl-Murley评分法评定疗效,优19例,良2例,可1例,优良率为95.5%。结论:病灶清除植骨联合克氏针内固定治疗儿童肱骨近端病理性骨折具有创伤小、对骨折愈合影响小、避免二次切开取内固定等优点。

Observation on the Effect of Debridement and Bone Grafting Combined with Kirschner Wire Internal Fixation in the Treatment of Children with Pathological Fracture of Proximal Humerus

Objective:To investigate the clinical effect of debridement and bone grafting combined with kirschner wire internal fixation in the treatment of children with pathological proximal humeral fractures.Methods:From January 2015 to January 2017,22 children with pathological proximal humeral fractures were treated with debridement and bone grafting combined with kirschner wire internal fixation,whose clinical data were retrospectively analyzed.Postoperative complications,imaging findings,fracture healing time and clinical efficacy were observed.Results:Fracture healing was good in 21 children,with an average of 9 weeks.And there were no cases of delayed union or nonunion of fracture or needle infection in 21 children.Due to premature and excessive weight-bearing activities after the operation,1 children presented with a loose kirschner wire and angular fracture end.The Samfiento strut was fixed after reoperation,and the fracture healed in 12 weeks after surgery.Conmanl-Murley score was used to evaluate the efficacy.There were 19 cases of excellent,2 cases of good and 1 case of fair.The rate of excellent and good was 95.5%.Conclusion:There were less trauma and less effect on fracture healing,and secondary incision for internal fixation was avoided in the treatment of children with pathological fracture of froximal humerus by debridement and bone grafting combined with kirschner wire internal fixation.