新生儿股骨骨折  

Femoral fracture in the neonates

作　　者：曾裴[1] 戴祥麒[1] 

机构地区：[1]天津医院小儿骨科,300211

出　　处：《中华骨科杂志》2002年第5期307-308,共2页Chinese Journal of Orthopaedics

摘　　要：目的总结47例产伤所致新生儿股骨骨折的诊治体会。方法1971～1998年间产伤所致新生儿股骨骨折47例,男24例,女23例;剖宫产39例,产道分娩18例;均为不稳定性骨折,斜形30例,横形17例;全部采用保守方法治疗。结果临床骨折愈合情况:平均成角39.25°(15°～80°),平均短缩0.69cm(0.5～1.5cm)。47例中29例获得随访,平均随访时间58个月(12～168个月)。25例肢体等长,4例患肢较健侧长1cm。走路无跛行,患肢功能恢复满意,髋、膝关节活动正常,骨折坚强愈合。结论新生儿股骨骨折是产伤所致长管状骨骨折中最常见的,畸形严重,保守治疗很难达到解剖复位,但其生长发育旺盛,骨折愈合快,自我矫形和塑形能力极强。治疗应以简单易行、损伤小、痛苦小、减少并发症为原则的保守治疗方法为佳。治疗标准应将公认儿童股骨骨折短缩在1～2cm内,成角小于25°,旋转小于15°的标准放宽,不主张为追求解剖复位而采取反复多次复位或切开复位的方法。Objective To analyze the diagnosis and treatme nt of 47femoral fractures in the neonates.Methods The history records of neonatal femo ral fractures during the period from1971to 1998were reviewed.They included of 24boys and 23girls.Thirty-nine fractur es of the femur occurred in Cesarean section and 18during vaginal delive ry.All were unstable fractures,30o blique and 17transverse.All of them were treated conservatively.Results Twenty-nine of the 47cases were foll owed up with the mean period of58months(12to 168months).The average angular and shortening deformity was 39.25°(15°to 80°)and0.69cm(0.5to 1.5cm)respectively.Twenty-five cases we re without leg length discrepancy,4cases had their affected side 1cm longer than t he unaffected side.At final follow u p,ll of the patients could walk with normal gait,and the range of motion o f the hip and knee joint were normal.N o delayed union was found.Conclusion The deformity of the femoral fractur e in neonate is usually severe and dif ficult to get anatomical reduction with closed methods,the f emur of the neonate is of great potent ial of plasticity,and the union period is usually short.The treatment shou ld be simple,and the use of repetitiv ely close or open reduction must be avoided.The popular accepted crite ria of children shortening within 1-2cm,angulations within 25°and torsion within 15°should be enlarged in neonates.

关 键 词：新生儿 股骨骨折 治疗 病因 临床特点 诊断 

分 类 号：R722.141[医药卫生—儿科]