So sánh kết quả điều trị bảo tồn và phẫu thuật gãy 1/3 dưới hai xương cẳng tay trẻ em tại Bệnh viện Chấn thương Chỉnh hình thành phố Hồ Chí Minh=Results of conservative versus surgical treatment of distal third forearm fracture in children at Hospital for Traumatology and Orthopaedics of Ho Chi Minh city

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Tác giả: Phước Nhân Trương, Quang Đình Nam Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học Cộng đồng, 2024

Mô tả vật lý: tr.210-216

Bộ sưu tập: Metadata

ID: 253074

Thêm vào giỏ

Distal third fracture is the most common location. Treatments are conservative or surgical
improper indication will leave deformities that will affect the child’s pronation and supination function later on.Purposes: To compare the results of conservative and surgical treatment.Methods: This cross-sectional retrospective study was in patients ≤ 12 years old, treated at HTO for 5 years from March 2013 - April 2017.Results: The average follow-up time of our study is 43.3 ± 12.3 months, the shortest is 28 months, the longest is 78 months. According to Daruwalla criteria, surgical results in 100% bone healing and good functions, and conservative results in 1 case of limited pronation of the hand of 22 ̊
however, it was compensated by shoulder movement and did not require further intervention. “Very satisfied” conservation was statistically significantly higher than the surgery group (76.7% vs 43.3%, p=0.011).Conclusion: The bone healing rate of both treatment methods is high. Depending on the age, fracture type, fracture line, and displacement of each case as well as respecting the ability to remodel, choose the appropriate treatment method to give the best results.Gãy 1/3 dưới là vị trí thường gặp nhất ở cẳng tay. Điều trị có thể bảo tồn hoặc phẫu thuật
nếu không đúng cách sẽ để lại can lệch ảnh hưởng đến chức năng sấp – ngửa của trẻ về sau.Mục tiêu: So sánh kết quả của điều trị bảo tồn và phẫu thuật.Phương pháp nghiên cứu: Nghiên cứu hồi cứu cắt ngang mô tả các bệnh nhi ≤ 12 tuổi, được điều trị tại BVCTCH trong 5 năm từ tháng 03/2013 – 04/2017. So sánh giữa 2 phương pháp về thời gian lành xương, chức năng.Kết quả: Thời gian theo dõi trung bình của nghiên cứu là 43,3 ± 12,3 tháng, gần nhất là 28 tháng, lâu nhất là 78 tháng.Theo tiêu chuẩn Daruwalla: Phẫu thuật cho xương lành và cử động tốt là 100%, Bảo tồn ghi nhận có 1 trường hợp còn hạn chế cử động sấp bàn tay hạn chế 220 so với tay lành, và bù trừ bằng cử động khớp vai nên không cần can thiệp tiếp theo. Nhóm bảo tồn “rất hài lòng” cao hơn so với nhóm phẫu thuật có ý nghĩa thống kê (76,7% so với 43,3%, p=0,011).Kết luận: Tỉ lệ lành xương của cả 2 phương pháp điều trị đều cao. Tùy vào lứa tuổi, kiểu gãy, đường gãy, độ di lệch của từng trường hợp cũng như tôn trọng khả năng tự điều chỉnh mà lựa chọn phương pháp điều trị thích hợp để cho kết quả tốt nhất.

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