Abstract: Objective To explore the clinical efficacy of longitudinal fixation with a single Kirschner pin in closed reduction for severely displaced juxta-epiphyseal fracture of the proximal phalanx in children. Methods A retrospective analysis of 24 cases of juxta-epiphyseal fracture of the proximal phalanx in children were performed, in whom treated with closed-displacement single Kirschner pin longitudinal fixation from January 2018 to December 2020. All of them were acute closed fractures, diagnosed by X-ray before operation, and of them were severely displaced （type Ⅱ） juxta-epiphyseal fracture according to the Campbell's line, all were successfully closed-displaced and single Kirschner pin longitudinally fixated, and followed up regularly after operation. The function and growth of the affected fingers were observedduring regular follow-up after operation. Results The follow-up period ranged from 40 to 69 months, with an average of 51.23 months. All the children had healed the fracture at outpatient review, and the average healing time was 3.5 weeks. All cases were rated as excellent according to the hand function evaluation criteria in the trial standards for upper limb functional assessment by the Hand Surgery Society of the Chinese Medical Association, with no complications such as infection, skin necrosis, nonunion, premature physeal closure, or severe malunion of fingers. Conclusion Close dreduction longitudinal fixation with a single Kirschner pin can achieve satisfactory results in treating severely displaced juxta-epiphyseal fracture of the proximal phalanx in children.

Key words: children, finger phalanges, juxta-epiphyseal fracture, single Kirschner pin longitudinal fixation

摘要： 目的 探讨闭合复位单枚克氏针纵向固定治疗儿童近节指骨严重移位型骨骺旁骨折的临床疗效。方法 回顾性分析自2018年1月至2020年12月采用闭合复位单枚克氏针纵向固定治疗的24例儿童近节指骨骨骺旁骨折,均为急性闭合性骨折,术前经X线片确诊,按Campbell线分型,均为严重移位型（Ⅱ型）骨骺旁骨折,均闭合复位成功,单枚克氏针纵向固定,术后定期随访观察患指功能及生长情况。结果 患儿随访时间为40~69个月,平均51.23个月,所有患儿门诊复查骨折均愈合,平均愈合时间为3.5周。全部病例按中华医学会手外科学会上肢部分功能评定试用标准中手功能评定标准评定均为优,未发生感染、皮肤坏死、骨不连、骺板早闭、手指严重畸形愈合等并发症。结论 闭合复位单枚克氏针纵向固定治疗儿童近节指骨严重移位型骨骺旁骨折可取得满意的疗效。

关键词: 儿童, 指骨, 骨骺旁骨折, 单枚克氏针纵向固定