闭合复位刚性髓内钉治疗大龄、高体重儿童及青少年股骨干骨折  

Close Reduction and Rigid Intramedullary Nailing Fixation of Femoral Shaft Fracture in Older and Over-weighted Children and Adolescent

作　　者：孙亮[1] 白锐[1] 刘万林[1] 赵振群[1] 王勇[1] 孟晨阳 Sun Liang;Bai Rui;Liu Wanlin(Department of pediatric orthopedics,the Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,China)

机构地区：[1]内蒙古医科大学第二附属医院小儿骨科,内蒙古呼和浩特010030

出　　处：《实用骨科杂志》2020年第10期873-876,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨闭合复位刚性髓内钉治疗大龄、高体重儿童及青少年股骨干骨折临床疗效及手术技巧。方法我院自2010年1月至2018年6月使用闭合复位刚性髓内钉内固定术治疗的大龄、高体重儿童及青少年股骨干骨折患者共25例。男19例,女6例;年龄10~18岁,平均(13.52±2.49)岁;左侧18例,右侧7例;体重42~75 kg,平均(50.35±7.54)kg。术后进行临床疗效、影像学结果及并发症分析。结果所有患者中无股骨头缺血坏死、股骨近端畸形、双下肢不等长、骨的延迟愈合及不愈合、功能障碍等并发症发生。其中1例(4%)出现术后感染,其后通过骨水泥珠链治愈。末次随访时髋关节功能Harris评分及美国膝关节协会(the American knee society,AKS)评分,优20例,良4例,可1例,优良率96%。结论大龄、高体重儿童及青少年股骨干骨折使用闭合复位刚性髓内钉内固定术治疗取得了满意的治疗效果,是一种可行的治疗选择。Objective To explore the close reduction and rigid intramedullary nailing fixation of femoral shaft fracture in older and over-weighted children and adolescent.Methods Our hospital used closed reduction rigid intramedullary nail internal fixation to treat 25 cases of older and over-weighted children and adolescent with femoral shaft fractures from January 2010 to June 2018.There were 19 males and 6 females,18 cases had the left side fracture and 7 cases had the right side fracture.The patients had an average age of(13.52±2.49)years(range:10~18)and a average weight of(50.35±7.54)kg(42~75).We analyzed the postoperative clinical,radiological results and complications.Results All patients had no complications such as avascular necrosis of femoral head,proximal femoral deformity,unequal length of both lower limbs,delayed healing and non-union of bone,dysfunction and other complications.One of them(4%)developed postoperative infection,which had been cured.At the last follow-up,Harris function score and knee function function AKS score:20 cases were excellent,80%;4 cases were good,16%;1 case was acceptable,4%.Conclusion Femoral shaft fractures in older and over-weighted children and adolescent are extremely challenging fractures.The use of closed reduction rigid intramedullary internal fixation can achieved satisfactory treatment results and is a feasible treatment option.

关 键 词：闭合复位 刚性髓内钉 股骨干骨折 儿童 青少年 

分 类 号：R683.42[医药卫生—骨科学]