应用Kapandji技术克氏针固定儿童不稳定桡骨远端骨折

S. Shrestha, D. Shrestha, Dipendra Kc, P. Karki, Sushil Yogi
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引用次数: 1

摘要

儿童不稳定桡骨远端骨折在保守治疗下更易移位导致畸形。近年来,Kapandji技术的k -钢丝固定越来越多地用于复位和维持这些骨折。目的:本研究的目的是评估Kapandji技术在不稳定桡骨远端骨折中的k针固定的有效性。方法:在班克Kohalpur尼泊尔医学院及教学医院采用Kapandji法对儿童桡骨远端不稳定骨折进行了横断面观察研究。结果:28例6 - 14岁儿童桡骨远端不稳定骨折采用一根局灶内k -丝和一或两根额外的局灶k -丝加强固定。前臂用肘部以上板/石膏固定4至6周。在手术4到6周的时间内取出k形针,并随访4个月。患者平均年龄为8.57±1.79岁。该技术使所有骨折接近解剖复位。在任何情况下都没有复位损失或再操作。根据改良梅奥腕关节评分,24例骨折均愈合,功能预后良好。针道感染等并发症较少。结论:Kapandji技术的k -钢丝固定,杠杆复位方法,作为一种额外的工具,有助于实现接近解剖对齐,并在整个愈合期间保持复位。所以这是一种有利的技术。
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Kirschner’s Wires Fixation of Unstable Distal Radius Fractures in Children with the Kapandji Technique
Introduction: Unstable distal radius fractures in children have more tendencies to get displaced with conservative management resulting into deformity. This Kapandji technique of K-wire fixation is on rise to reduce and maintain these fractures in recent days. Aims: The aim of this study was to evaluate the effectiveness of the K-wires fixation in unstable distal radius fracture with Kapandji techniques. Methods: A cross-sectional observational study was conducted in Nepalgunj Medical College and Teaching Hospital, Kohalpur, Banke in unstable distal radius fracture in children with K-wires fixation using Kapandji method. Results: Twenty eight unstable distal radius fractures in children between 6 to 14 years of age were treated with one intrafocal K-wire and one or two extra focal K-wires to augment fixation. Immobilization of forearm with above elbow slab/cast for four to six weeks was enforced. K-wires were removed between four to six weeks of operation depending upon the union and followed prospectively for four months. The mean age of patients presented was 8.57± 1.79 years. This technique brought near anatomical reduction in all fractures. There was no reduction loss or remanipulation in any case. All fractures achieved union and functional outcome was excellent in 24 cases based on Modified Mayo Wrist Score. There was fewer complications like pin tract infection. Conclusion: This Kapandji technique of K-wire fixation, leverage reduction method, being an additional tool helps to achieve near anatomical alignment, and maintain reduction throughout the duration of healing. So it is an advantageous technique.
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