肱骨交锁髓内钉治疗青少年股骨干骨折对股骨近端发育的影响  

Effect of humeral interlocking intramedullary nail on growth of proximal femur after treatment of femoral shaft fracture in adolescent

作　　者：陈顺有[1] 潘源城[1] 林然[1] 陈辉[1] 唐伟华[1] 黄殿华[1] 蓝少泽 林清坚[1] 

机构地区：[1]厦门大学附属福州第二医院儿童骨科,福建福州350007

出　　处：《中国矫形外科杂志》2016年第22期2045-2048,共4页Orthopedic Journal of China

摘　　要：[目的]通过测量术后随访X线片的股骨近端几何结构参数,了解经大转子进钉应用肱骨交锁髓内钉治疗青少年股骨干骨折对股骨近端发育的影响。[方法]回顾性分析2011年11月-2014年2月本科25例10-15周岁经大转子进钉应用肱骨交锁髓内钉治疗青少年股骨干骨折的患者,所有病例随访至至少骨性愈合,以健侧为对照组,收集最近一次随访的术后X线片,应用PACS处理软件测量其股骨近端几何结构参数,包括股骨近端颈干角（CDA）、关节面转子间距离（ATD）、转子间距（TTD）、关节面小转子间距（ALD）、股骨头中心至小转子距离（CSD）、股骨颈最宽径（FND）以及股骨头最宽径（FHD）。[结果]所有患儿均获得随访,平均年龄12.24岁,平均随访时间为25.6个月。术后X线片显示2例患者术后出现大转子骨骺吸收现象,患侧的股骨近端几何参数与健侧相比差异均无统计学意义。[结论]经大转子进钉应用肱骨交锁髓内钉治疗青少年股骨干骨折疗效满意,可以避免对股骨近端发育的影响。[ Objective] To observe the effect of humeral interlocking intramedullary nail through the greater trochanter on the growth of proximal femur in the treatment of adolescent femoral shaft fracture by measuring the geometric parameters of prox- imal femur on X - ray in postoperative follow - up. [ Method ] A retrospective analysis was performed on 25 adolescents with femoral shaft fracture aged from 10 to 15 years who were admitted to our department from November 2011 to February 2014, and were treated with humeral interlocking intramedullary nail through the greater trochanter. All the cases were followed up until they achieved at least bony union. The healthy sides were taken as the control group. The latest postoperative X - ray findings in the latest follow -up were collected, and PACS software was used to measure the geometric parameters of the proximal femur, in- cluding collodiaphyseal angle of the proximal femur, articulo - trochanteric distance, trochanter - trochanter distance, articulo - lesser trochanter distance, distance from the center of femoral head to lesser trochanter, femoral neck diameter, and femoral head diameter. [ Result ] The mean age of the 25 adolescents was 12.24 years, and all of them were followed up, with a mean follow - up time of 25.6 months. Postoperative X - ray showed that 2 cases had epiphysis absorption of the greater trochanter after sur- gery. The X - ray during postoperative follow - up showed no significant differences in geometric parameters of the proximal fe- mur between the affected side and the healthy side. [ Conclusion ] Humeral interlocking intramedullary nail through the greater trochanter is an effective approach in the treatment of femoral shaft fractures in adolescents, and it can avoid the adverse effect on the growth of proximal femur.

关 键 词：青少年 股骨干骨折 肱骨交锁髓内钉 股骨近端 

分 类 号：R726.8[医药卫生—儿科]