钛制弹性髓内钉固定治疗儿童股骨干长螺旋形骨折  

Titanium elastic intramedullary nailing for femoral long spiral fractures in children

作　　者：徐会法[1] 黄鲁豫[1] 雷伟[1] 黄耀添[1] 刘艳武[1] 李天清[1] 

机构地区：[1]西安第四军医大学西京骨科医院,710032

出　　处：《中华创伤骨科杂志》2014年第2期137-140,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨钛制弹性髓内钉（TEIN）崮定治疗儿童股骨干长螺旋形骨折的疗效？方法l回顾怍分析2010年8月至2012年6月收治的18例儿童股骨干长螺旋形骨折患者资料，男13例，女5例；年龄为2岁2个月至6岁，平均3．5岁；骨折类型均为长螺旋形骨折。所有患者均采用闭合复位．住C型臂X线机监视下逆行穿入TEIN内固定。术后石膏或支具同定4周，4周后开始配戴支具进行小负重功能锻炼。结果18例患儿术后获平均13个月（9-20个月）随访。骨折愈合时间为3～5个月，平均3．5个月。未次随访时按照Flynn等提出的弹件髓内钉治疗股骨骨折的疗效标准评定疗效：优17例，良l例。5例患儿钉尾刺激皮肤出现过敏“激惹”现象，拔除TEIN后迅速愈合；1例患儿患肢较对侧下肢长1．1cm。所有患者未发生骨髓炎、骨折延迟愈合或小愈合、断钉、钉脱出及骨骺损伤等并发症。结论TEIN同定治疗儿童股骨干长螺旋形骨折具有创伤小、不损伤骨骺、骨折愈合良好、患肢功能恢复快及并发症少等优点，是一种有效、可靠的方法。Objective To report titanium elastic intramedullary nailing （TEIN） for femoral lung spiral fractures in children. Methods From August 2010 to June 2012, 18 children with femoral long spiral fracture were treated in our department. They were 13 boys and 5 girls, aged from 2 years and 2 months to 6 years （average, 3.5 years）. Fractures were reduced closely and fixated with retrograde TEIN under C-arm fluoroscopy. Functional rehabilitation with cast was enforced for another 2 to 4 weeks after external fixation with plaster or brace for 4 weeks. Results The 18 cases were followed up for an average of 13 months （from 9 to 20 months）. Their fractures healed after 3 to 5 months （average, 3.5 months）. According to the evaluation criteria proposed by Flynn for TEIN of femoral fractures, 17 cases were rated as excellent amt one as fine at the last follow-up. Five cases reported nail site irritation which was relieved after removal of the nails. One patient showed a longer length （1.1 cm） of the affected leg compared with the normal one. No infection, delayed union, nonunion, broken nail, or injury to the femoral or tibial epiphysis was reported. Conclusion Treatment of the femoral long spiral fractures in children with TEIN is effective and reliable, because of minimal invasion, no interference with the epiphysis, quick functional recovery and limited com- plications.

关 键 词：股骨骨折 骨折固定术 髓内 骨钉 外科手术 微创性 儿童 

分 类 号：R726.8[医药卫生—儿科]