经皮弹性髓内钉治疗儿童股骨粉碎性骨折疗效观察  

Elastic intramedullary nails(TENs) for femoral shaft complicated fractures in children by percutaneous treatment

作　　者：王远辉[1] 叶里子[1] 万永鲜[1] 田泽高[1] 谭美云[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,四川泸州646000

出　　处：《四川医学》2012年第12期2074-2075,共2页Sichuan Medical Journal

摘　　要：目的探讨经皮弹性髓内钉治疗儿童股骨粉碎性骨折的疗效。方法采用手法复位、C臂X线监视、经皮弹性髓内钉内固定治疗37例4～10岁的股骨粉碎性骨折患儿,术后髋人字石膏外固定4～6周后拆除,并于术后6～9个月取出内固定,继续观察患肢长度及行走步态。结果所有患者都进行随访,随访时间6～24个月不等,术后无1例出现感染、骨折不愈合、弹性髓内钉松动脱出等并发症,5例患儿有针尾激惹,5例患儿出现0.5～1.0cm的双下肢不等长;术后9～13周患儿逐渐下地负重行走,并于术后6～9个月取出内固定,术后12个月所有患儿膝关节屈伸功能不受限,行走步态无异常,术后18个月所有出现双下肢不等长的患儿自行恢复。结论采用手法复位、经皮弹性髓内钉内固定及髋人字石膏外固定治疗儿童股骨粉碎性骨折损伤小,骨折愈合好,患肢功能恢复快,并发症少,是治疗儿童股骨粉碎性骨折简便、有效的治疗方法。Objective To investigate the curative effect of elastic intramedullary nails（TENs） lot femoral shaft complicat- ed fractures in chihlren by percutaneous treatment. Methods Manual reduction, C-arm X-ray monitoring, percutatleous TENs fixation treatment of 37 patients 4 to 10 years old children with femoral fractures, postoperative hip spica cast immobilization, 4 to 6 weeks ＂,after removal of cast imalobilization, and ＇after 6 to 9 months out of fixation, continued to observe the lintb length and gait. Results In all cases were followed up for 6 to 24 months, no case of postoperative infection, nonunion, TENs loose prolap..,c and other complications, 5 cases of children with pintail irritability, and 5 cases of children with lower lind） length inequality 0. 5 1.0cm ; 9 to 13 weeks ,after the children gradually come down to earth weight-bearing walking, and after 6 to 9 months to remove the internal fixation, all children 12 nmnths after knee flexion anti extension function was not limited, no abnormal gait, aitet 18 months of double-leg length of all the children on their own recovery. Conclusion Treatment of femoral shaft complicated ltac- tures in children with TENs by reduction, percutaneous fixation of TEN and hip spica cast immobilizatio, has advantages ol mini- real invasion, quick fracture healing, quick recovery of limb function, fewer complications. It is a simple and effcclivc method ol trealnlent.

关 键 词：弹性髓内钉 股骨干骨折 儿童 

分 类 号：R726.8[医药卫生—儿科]