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作 者:周炎[1] 刘世清[1] 肖胜军 瞿新丛 方祖怡 刘祥 潘晓辉
机构地区:[1]武汉大学人民医院骨科,湖北武汉430060 [2]罗田县人民医院骨科,湖北罗田438600
出 处:《中国骨伤》2014年第10期804-808,共5页China Journal of Orthopaedics and Traumatology
摘 要:目的:探讨低龄儿童股骨干骨折应用踝背伸位桥式钢丝夹板外固定的治疗方法及临床疗效.方法:借鉴拱桥力学原理及结构形式设计踝背伸位桥式钢丝夹板,并于2006年6月至2012年6月应用于45例低龄儿童股骨干骨折的治疗.其中男31例,女14例;年龄8个月~5.5岁,平均3.2岁;股骨上1/3骨折14例,中1/3骨折26例,下1/3骨折5例;横形骨折20例,斜形骨折14例,螺旋形骨折6例,粉碎性骨折5例.定期复查X线片,随访观察影像学改变、并发症及临床疗效.结果:45例患几随访6~21个月,平均12个月,骨折均在固定后5~7周(平均6周)达临床愈合.7例出现患肢软组织并发症,包括臀部压疮,足背及跟腱部表皮坏死等,经局部换药及拆除外固定后均愈合.随访期间原重叠、成角及倒方移位者经自身塑形改造,患肢均恢复正常力线关系及骨结构.根据Flynn临床疗效标准,优35例,良8例,可2例.结论:踝背伸位桥式钢丝夹板外固定治疗低龄儿童(6岁以内)股骨干骨折安全可行,操作简单,疗效满意,值得基层医院推广运用.Objective:To explore the technique and therapeutic effect of bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral shaft fractures in young children.Methods:From June 2006 to June 2012,45 young children with femoral shaft fractures were treated by bridge wire splint fixation with ankle dorsiflexion,which was designed according to arch bridge mechanical principle and structure.There were 31 males and 14 females with an average age of 3.2 years old ranging from 8 months to 5.5 years old; 14 cases were upper 1/3 femoral fractures,26 cases were middle 1/3 femoral fractures,5 cases were lower 1/3 femoral fractures;20 cases were transverse fractures,14 cases were oblique fractures,6 cases were spiral fractures,and 5 cases were comminuted fractures.X-ray,follow-up imaging changes,clinical curative effect and complications were assessed.Results:Forty-five patients were followed up for 6 to 21 months (averaged 12 months).All fractures were reached clinical bone healing after 5 to 7 weeks (averaged 6 weeks) fixation.Seven cases appearred limb soft tissue complications,including buttocks bedsore,dorsal foot and Achilles tendon epidermal necrosis,and healed after dressing and removal of external fixation.During follow-up,the original overlap angle and lateral displacement were remodeled,and limbs were restored to the normal line of force and bone structure.According to Flynn standard,35 cases got excellent results,8 cases good,2 cases fair.Conclusion:The bridge wire splint fixation with ankle dorsiflexion for the treatment of femoral shaft fractures in young children (less than 6 years old) is safe,feasible,simple,and has raliable effect,which can be applied in primary hospitals.
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