弹性髓内钉治疗儿童股骨干骨折35例经验及文献综述  

The efficacy of elastic intramedullary nailing fixation for the treatment of children′s femoral shaft fracture

作　　者：王正飞[1] 盛晓文[1] 薛峰[1] WANG Zhengfei SHENG Xiaowen XUE Feng(Department of Orthopaedics, Changshu NO.1 People＇s Hospital, Changshu, Jiangshu 215500, China.)

机构地区：[1]苏州大学附属常熟第一人民医院骨科,江苏常熟215500

出　　处：《岭南现代临床外科》2017年第1期93-98,共6页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨弹性髓内钉治疗儿童股骨干骨折的效果并文献综述。方法 2007月7月至2014年6月,采用弹性髓内钉治疗儿童股骨干骨折35例,男28例,女7例,年龄5~13岁,平均年龄9.2岁,评估手术时间、术中出血量、住院时间、负重时间,骨折愈合时间及疗效评估。结果手术平均持续65 min(45~95 min),平均失血量为70 mL,平均住院8天(6~14天)。本组病例术后随访6~20个月,平均约14个月。所以患者均获得一期愈合,愈合时间6~9周,平均愈合时间约7.5周。无术后感染、骨不连、断钉、骨骺损伤等并发症发生。其中2例有钉尾激惹导致膝部皮肤轻度疼痛,在内固定取出疼痛消失。术后一年测量发现15例肢体不等长情况,其中3例患肢短缩,12例患肢延长,但均在1.5 cm内,对患者的行走无明显影响,并在随后的随访中发现肢体不等长现象得到纠正。按Flynnetal治疗评价标准测定,治疗效果痊愈31例,良好4例。结论弹性髓内钉治疗稳定性儿童股骨干骨折,具有手术时间短、失血量少、创伤小等优点。Objective To investigate the efficacy of elastic intramedullary nailing fixation forthe treatment of children′s femoral shaft fracture and to review published literature. Methods BetweenAugust 2003 and June 2014,35 patients（28 males and 7 females）with a mean age of 9.2 years（rangefrom 5 to 13 years）were treated with the plate fixation in our institute. The hospital stay,operative time,surgical incision,intraoperative blood loss,full weight bearing time,time of fracture healing andcomplications were evaluated and reviewed by literaturce. Results The mean surgical time was 65 min（range from 45 to 95 min）. The mean blood loss was 70 m L. The mean period of hospital stay was 8 days（range from 6 to 14 days）. All fractures recovered with the mean time of fracture healing of 7.5 weeks（range from 6 to 9 weeks）after mean 14 months（range from 6 to 20 months）follow up. No nonunion,delayed union,infection,refracture occurred during fllow-up. Two patients experienced pain due tothe irritation of nail end and relieved after removal of nail. Three cases presented with shortening ofwound legs and 12 cases experienced overgrowth,within 1.5 centimeter leg length discrepancy atone-year-followup. Spontaneous recovery was observed in all cases during period of follow-up. Excellentrate was 89% according to the score system of Flynnetal. Conclusion Elastic intramedullary nail fixationis a minimal invasive and effective method to treat the children′s femoral shaft fractures.

关 键 词：儿童 股骨干 骨折 弹性髓内钉 

分 类 号：R683.42[医药卫生—骨科学]