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目的探讨儿童及青少年西摩骨折的治疗方法及疗效。方法回顾分析2013年1月-2015年11月收治的26例儿童及青少年西摩骨折患者临床资料。男18例,女8例;年龄1岁1个月~17岁,中位年龄8.2岁。致伤原因:挤压伤14例,重物砸伤10例,戳伤2例。损伤指别:拇指2例,示指1例,中指12例,环指6例,小指5例。受伤至手术时间1~15 h,平均3.2 h。入院后行清创、拔甲、甲基质修补、闭合复位克氏针固定、石膏外固定治疗。术后4周去除克氏针及石膏,行手指功能锻炼。结果术后切口均Ⅰ期愈合,无感染等早期并发症发生。26例均获随访,随访时间2~24个月,平均12.3个月。X线片复查示,骨折均愈合,愈合时间1~2个月,平均1.4个月;无骨折畸形愈合、骨折再移位、骨骺早闭及甲板不能生长等并发症发生。1例术后出现甲板畸形,无需手术处理。末次随访时1例患者伤指远指间关节伸直受限约10°,屈曲正常;其余患者伤指远指间关节屈伸活动范围为0~75°,与健侧的0~78°相比无显著差异。结论对于儿童及青少年西摩骨折,急诊行清创、拔甲、甲基质修补、闭合复位克氏针固定治疗可获满意疗效。
Objective To investigate the treatment and efficacy of Semen fractures in children and adolescents. Methods The clinical data of 26 children and adolescents with Semen fractures admitted from January 2013 to November 2015 were retrospectively analyzed. 18 males and 8 females; aged 1 year 1 month to 17 years old, the median age of 8.2 years old. Causes of injury: crush injury in 14 cases, 10 cases of heavy injury, pounding in 2 cases. Damage refers to: the thumb in 2 cases, index finger in 1 case, middle finger in 12 cases, ring finger in 6 cases and little finger in 5 cases. Injured to surgery 1 ~ 15 h, an average of 3.2 h. After admission, debridement, dissection, nail repair, closed reduction Kirschner wire fixation, plaster external fixation. 4 weeks after removal of Kirschner wire and gypsum, finger functional exercise. Results Postoperative incision healed by first intention without any complications such as infection. Twenty-six patients were followed up for 2-24 months with an average of 12.3 months. X-ray examination showed that the fracture healed, the healing time of 1 to 2 months, an average of 1.4 months; no fracture malunion, fracture and then shift, epiphyseal early closure and the deck can not grow and other complications. One case of deformity occurred after the operation, without surgical treatment. One patient in the last follow-up showed that the distal interphalangeal joint was limited to about 10 ° in extension and normal in flexion. The flexion and extension range of the distal interdigital flexion was 0-75 ° in the rest of the patients, compared with that in the contralateral 0-78 ° No significant difference. Conclusion Semen fractures in children and adolescents, emergency debridement, debridement, nail repair, closed reduction Kirschner wire fixation can be satisfied with satisfactory results.