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目的 探讨闭合撬拨复位克氏针固定治疗儿童难复性指骨颈骨折的临床疗效.方法 自2016年1月至2019年3月,我们共收治12例难复性指骨颈骨折患儿,受伤至手术时间为1～46d,其中陈旧性骨折5例.手术均采用闭合克氏针穿刺清理骨痂、撬拨复位骨折断端,而后克氏针固定.术后随访患儿骨折愈合时间并采用手指关节总活动度(total active motion,TAM)系统评定法来评价患指功能恢复情况.结果 术中所有患儿均闭合撬拨复位成功,术后未发生感染、皮肤坏死、骨折畸形愈合等并发症.所有患儿均获得随访,时间为6～36个月,平均15.3个月.骨折愈合时间为(4.2±0.2)周,术后4周拔除克氏针,行功能锻炼,手指关节功能根据TAM系统评定法评定均为优.结论 闭合撬拨复位克氏针固定治疗儿童难复性指骨颈骨折具有手术操作简单、创伤小、疗效确切等优点,对于陈旧性骨折需严格把握手术指征.“,”Objective To investigate the clinical efficacy of closed percutaneous reduction by leverage and Kirschner wire fixation in the treatment of irreducible phalangeal neck fractures in children.Methods From January 2016 to March 2019,12 children with irreducible phalangeal neck fractures ware treated.The time from injury to operation was 1 to 46 days,including 5 cases of old fracture.Closed Kirschner wire puncture was used to clear callus and closed percutaneous reduction by leverage and Kirschner wire fixation were performed.The fracture healing time of the children was followed up after operation.Total active motion (TAM) system was used to evaluate the recovery of finger function.Results All the operations were completed successfully,and no infection,skin necrosis and fracture malunion occurred.All the children were follow-up for 6 to 36 months,with an average of 15.3 months.The fracture healing time was (4.2±0.2) weeks.The Kirschner wire was removed and functional exercises were performed 4 weeks after operation.The finger joint function was evaluated as excellent according to TAM system.Conclusion Closed percutaneous reduction by leverage and Kirschner wire fixation in the treatment of irreducible phalangeal neck fractures in children has the advantages of simple operation,less trauma and definite curative effect.It is necessary to strictly grasp the operative indications for old fracture.