弹性髓内针治疗儿童长骨骨折  

Treatment of Long Bone Fracture in Children with Flexible Intramedullary Nail

作　　者：周曙光[1] 陈建雯[1] 俞辉国[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院儿外科,上海200025

出　　处：《实用骨科杂志》2012年第4期306-308,378,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨弹性髓内针固定治疗儿童长骨骨折的并发症及预后。方法回顾性总结我院2004年1月至2010年5月收治的47例儿童非粉碎性长骨骨折,包括肱骨骨折、尺骨桡骨骨折、股骨骨折、胫骨骨折。47例患儿中,男性27例,女性20例;年龄6~14岁。肱骨骨折6例,尺桡骨骨折20例,股骨骨折15例,胫骨骨折6例。对于尺桡骨骨折,采用麻醉下闭合复位,单根弹性髓内针固定,石膏固定2~3周后自主活动。对于肱骨、股骨、胫骨骨折,采用麻醉下闭合复位,双根弹性髓内针交叉固定。肱骨骨折后石膏固定3周后自主活动;股骨、胫骨骨折石膏固定5~6周,8~10周后完全负重行走。结果 47例患儿经弹性髓内针内固定治疗后,骨痂生长良好,均获治愈,并且关节功能恢复正常,无严重的并发症。结论术前合理选择患儿年龄、骨折类型,采用弹性髓内针治疗儿童长骨骨折,具有微创、安全、简便、复位好、恢复快和并发症少的优势。Objective To explore the results of using flexible intramedullary nails in the treatment of children′s long bone fractures.Methods From 2004 to 2010,47 children（47male,20 female） with non-crash long bone fractures were analysed retrospectively.Fracture of humerus,fracture of radius and ulna,fracture of femur,fracture of tibia were included.The patients were 6~14 years old.There are fracture of humerus in 6 patients,fracture of radius and ulna in 20 patients,fracture of femur in 15 patients,fracture of tibia in 6 patients,the fracture of radius and ulna affected children were treated by closed reduction,fixing of single flexible intramedullary nail.After 2~3 weeks of fixation,autonomic activities are allowed.Fracture of humerus、femur and tibia were reducted,fixed with two flexible intramedullary nails.After 3 weeks of fixation,autonomic activities of pectoral limb are allowed.In humeral fracture patients children with femur or tibia fracture were fixed for 5~6 weeks.The patients were allowed to walk after 8~10 weeks.Results All the fractures were cured.Full range of motion in the nearby joints was reserved.No severe complications were found.Conclusion For suitable patients,the therapy using flexible intramedullary nails is a safe,easy and minimal invasive technique.The affected children recovered quickly with fewer complications.

关 键 词：弹性髓内针 长骨骨折 治疗 儿童 

分 类 号：R683.4[医药卫生—骨科学]