弹性髓内钉治疗儿童长干骨骨折中并发症的分析  

Analysis on complications of elastic nail treating children's long bone fractures

作　　者：姚陆丰[1] 陈秋[1] 仲肇平[1] 徐荣明[1] 王浩然[1] 彭琳瑞[1] 任荣[1] 

机构地区：[1]宁波市第六医院骨科,浙江宁波315040

出　　处：《中国骨伤》2009年第2期98-100,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨弹性髓内钉治疗儿童长骨骨折并发症的原因。方法:应用弹性髓内钉治疗儿童长骨骨折66例(75个部位),男49例,女17例;年龄3～17岁,平均7.8岁。其中股骨35例(2例双侧),胫腓骨骨折20例(12例为胫骨骨折),尺桡骨8例(单纯尺骨1例),肱骨3例。开放骨折4例,闭合骨折62例,均为新鲜骨折,无多段骨折。合并脑、胸等复合伤3例。均采用闭合复位或切开复位、弹性髓内钉固定,术后石膏托或支具有限固定1个月。术后定期复查X线片。复查内容包括:关节功能,针尾情况,X线片骨痂生长情况,记录并发症及处理。结果:全部病例均获随访,随访时间12～29个月,平均19个月。并发症:骨不愈2例,进针点或骨折端骨折劈裂2例,骨折端移位1例,关节活动受限4例,针尾激惹3例,骨折畸形愈合1例。结论:严格把握手术指征、精心的术前设计、规范的操作是避免手术并发症的有效手段。Objective：To analyze the reasons on complications of treatment with elastic nail in children＇s long bone fracture. Methods：Sixty-six cases （75 parts of long bone fratures） were treated by elastic nail including 4-9 male and 17 female. The age ranged from 3 to 17years, mean 7.8 years. There were 35 femur fractures （2 cases were hibateral）, 20 tibia and fibula fractures （12 cases were tibia fractures）, 8 radial fractures （1 case was ulna fracture） and 3 humerus fractures. The cases included 4 open fractures and 62 closed fractures. All cases were fresh fractures,no multi-segmental fractures. Three cases associated with brain and chest injuries. These cases were treated by open or closed reduction and internal fixaion with elastic nail. A cast or brace had been used after operation for a month. Following-up included the function of the joint, the bottom of the nail and the callus. Complications were timely recorded. Results：All the patients were followed-up for 12 to 29 months, averaged 17 months. The cases occurrenced compilications including 2 cases of nonunion ,2 of new fracture, 1 of displacment,4 of joint dysfunction, 3 of irritation of the bottom of the nail and 1 malunion. Conclusion：Strict indication, well design, canonical operation is a good way to avoid compliacations. At the same time, early treatment can reduce the sequela.

关 键 词：长骨骨折 骨折固定术 髓内 并发症 儿童 

分 类 号：R683[医药卫生—骨科学] R683.42[医药卫生—外科学]