弹性钉与钢板固定治疗大年龄儿童前臂双骨折的疗效比较  

Flexible nailing and plating for forearm shaft fractures in older children

作　　者：张中礼[1] 杨建平[1] 蔡少华[1] 龚仁钰[1] 孙永胜[1] 曾裴[1] 王春会[1] 

机构地区：[1]天津市天津医院小儿骨科,300211

出　　处：《中华小儿外科杂志》2009年第8期510-513,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的回顾性分析并比较应用弹性髓内钉与钢板固定治疗大年龄儿童（〉8岁）前臂双骨折的治疗结果。方法分析1999-2007年我院收治的前臂双骨折病例资料，根据治疗方法对将41例（平均年龄9．7岁）入选病例分为两组，24例行弹性髓内钉固定17例行切开复位钢板固定。回顾分析比较并发症、骨折愈合及前臂功能。结果两组在年龄、AO骨折分型方面差异无统计学意义，受伤至手术时间钢板组显著高于弹性钉组。手术时间、止血带使用时间及出血量，弹性钉组显著低于钢板固定组。骨折愈合情况（术后3个月与6个月）、末次随访时前臂旋转活动丢失、严重与轻微骨折并发症发生率两组差异并无统计学意义。结论对于大龄儿童尺、桡骨干骨折手术治疗，弹性钉与钢板固定在术后功能评估上无显著差异。新鲜前臂骨干双骨折，宜首选弹性髓内钉；对于开放、粉碎及陈旧骨折，建议行切开复位钢板固定。Objective To compare the outcomes of flexible nailing and plating for forearm shaft fractures in children older than 8 years of age. Methods Forty one patients were included in this study from 1999 to 2007, 24 patients underwent operative fixation with flexible nail, and 17 patients received open reduetion internal fixation （ORIF） with plates and screws. The two groups were compared retrospectively according to perioperative data and complication rates, loss of forearm rotation, bone union. Results There were no significant differences of age and fracture type between two groups. The time between injury and operation was longer in plate group. The duration of surgery was significantly shorter in the nailing group. Bone union （at three months and six months）, forearm rotation al last visit and complication rates （mild and severe） were similar in two groups. Conclusions For forearm shaft fractures in older children （older than 8）, functional outcomes are similar in flexible nail and plate groups. For fresh forearm shaft fracture, flexible nailing fixation remains an effective treatment. For open fracture, comminuted and old fracture, ORIF with plates and screws is our recommendation.

关 键 词：桡骨骨折 肱骨骨折 骨折同定术 髓内 

分 类 号：R686[医药卫生—骨科学]