Rush钉矫治成骨不全儿童股骨畸形的疗效观察  

Clinical efficacy of Rush rods in correction of femoral deformity in children 's tosteogenesis imperfecta

作　　者：宿玉玺[1] 赵仁欢 覃佳强[1] 张德文[1] 南国新[1] 王忠良[1] 蔡文全[1] 

机构地区：[1]重庆医科大学附属儿童医院骨科,儿童发育疾病研究教育部重点实验室,重庆400014

出　　处：《第三军医大学学报》2015年第3期238-242,共5页Journal of Third Military Medical University

基　　金：国家自然科学基金青年科学基金(81001197);重庆市自然科学基金(2010JJ0267);国家临床重点专科建设项目([2013]544)~~

摘　　要：目的探讨股骨多段截骨髓内钉固定矫治儿童成骨不全症所致股骨畸形的疗效,分析术后并发症的防治。方法 2007年1月至2013年12月,我院共收治成骨不全所致股骨畸形患儿28例,包括39根畸形股骨。年龄3岁7个月至14岁5个月,平均8岁4个月。术中将弯曲股骨行多段截骨矫形及髓内钉固定,平均截骨1.9（1～3）处,随机分为弹性针组与Rush钉组,其中20根股骨使用弹性髓内钉,19根股骨使用Rush钉。结果随访1年3个月至5年7个月,平均3年8个月。随访后期按Sanders评分标准评定髋关节功能：弹性针组优11例,良2例,中7例,差0例;Rush钉组优16例,良2例,中1例,差0例。结论多段截骨矫形后髓内钉内固定治疗儿童成骨不全所致股骨畸形,能有效矫正股骨弯曲畸形,改善下肢外观及力线关系,防止再骨折,提高患儿生活质量,效果明确。Rush髓内钉内固定效果满意,术后再骨折概率小,股骨不易再次弯曲变形,值得临床推广。Objective To determine the therapeutic effect of multi-section osteotomy and intramedullary fixation for correction of femoral deformity in the osteogenesis imperfecta children,and analyze the postoperative complications for prevention and treatment. Methods From Jan. 2007 to Dec. 2013,28 femoral deformity children with osteogenesis imperfect（ totally 39 sides of femoral deformity）,were selected and treated with multi-section osteotomy and intramedullary fixation in our hospital. Their ages ranged from 3years and 7 months to 14 years and 5 months,with an average age of 8 years and 4 months. During the operation,the average section of osteotomy was 1. 9（ 1 to 3）. The children were randomly divided into elastic pin internal fixation group（ 20 sides for elastic intrameduary nails） and Rush nail internal fixation group（ 19 sides for Rush nails）. Results All the patients were followed up for an average time of 3 years and8 months（ from 1 year 3 months to 5 years 7 months）. According to the Sanders grading standard to evaluate the hip function,11 cases were excellent,2 cases were good,7 cases were common and none was bad. For the children with Rush nails,16 cases were excellent,2 cases were good,1 case was common and none was bad. Conclusion Multi-section osteotomy and intramedullary fixation effectively corrects the femoral deformity in the osteogenesis imperfecta children,improves the appearance,changes the force relationship of the lower limbs,prevents fracture again,and promotes the life quality of the children. It is worth for wilder application with the effect of correction and low probability of fracture again and deformity of Rush nails.

关 键 词：成骨不全 股骨畸形 截骨矫形 髓内固定 

分 类 号：R687.33[医药卫生—骨科学] R726.811[医药卫生—外科学]