儿童股骨干骨折治疗方式的选择  

Selection of treatment methods for femoral shaft fractures in children

作　　者：宋凯 张池 丁凡[1] SONG Kai;ZHANG Chi;DING Fan(Department of Orthopedic Trauma,Jingmen NO.1 People's Hospital,Jingmen,Hubei 448000,China)

机构地区：[1]荆门市第一人民医院创伤骨科,湖北448000

出　　处：《中国骨与关节损伤杂志》2021年第12期1250-1253,共4页Chinese Journal of Bone and Joint Injury

基　　金：湖北省卫生健康委员会科研立项项目(WJ2019M075);荆门市重点科技计划项目(2020YFZD017)。

摘　　要：目的探讨儿童股骨干骨折治疗方式选择及其对预后的影响。方法回顾性分析自2014-01—2019-12诊治的52例儿童股骨干骨折,19例采用锁定钢板内固定(钢板组),11例采用弹性髓内钉固定(髓内钉组),6例开放性、复杂股骨干骨折于静脉全身麻醉下急诊行外固定架固定(外固定架组),16例采用双下肢垂直悬吊皮牵引并石膏夹板外固定治疗(牵引组)。结果非手术组年龄小于手术组,且外固定架组年龄小于钢板组、髓内钉组,差异有统计学意义(P<0.05)。手术组出现8例并发症(其中钢板组7例,髓内钉组1例),非手术组出现6例并发症,组间差异无统计学意义(P=0.252)。髓内钉组手术切口长度短于钢板组,外固定架组手术时间短于钢板组、髓内钉组,外固定架组住院时间短于钢板组、髓内钉组和牵引组,牵引组住院时间明显长于钢板组和髓内钉组,牵引组治疗总费用明显少于钢板组、髓内钉组和外固定架组,差异有统计学意义(P<0.05)。结论儿童股骨干骨折手术方式的选择更倾向于微创技术,髓内钉内固定已替代钢板内固定成为其首选手术治疗方式。非手术治疗在儿童股骨干骨折治疗中还占据着重要地位,对于学龄前儿童及经济状况较差的家庭来说,牵引仍是一种不可或缺的治疗方式。Objective To explore treatment options for children’s femoral shaft fractures and the influence on the prognosis.Methods A retrospective analysis was conducted on 52 cases of femoral shaft fractures in children diagnosed and treated fromJanuary 2014 to December 2019. Nineteen cases were fixed with locking plates(plate group), 11 cases were fixed with elastic in-tramedullary nails(intramedullary nail group), 6 open and complex cases femoral shaft fractures were treated with external fixa-tion in emergency under intravenous general anesthesia(external fixation group), and 16 cases were treated by skin traction andexternal fixation with plaster splint(traction group).Results The non-surgical group was younger than the surgical group, andthe external fixation group was younger than the plate group and the intramedullary nail group, the difference was statisticallysignificant(P<0.05). Eight cases had complications in the surgical group(7 in the plate group and 1 in the intramedullary nailgroup) and 6 in the non-surgical group, the difference wasn’t statistically significant(P=0.252). The surgical incision length ofthe intramedullary nail group was shorter than that of the plate group. The operation time of the external fixation group was short-er than that of the plate group and the intramedullary nail group. The length of hospital stay in the external fixation group wasshorter than that of the plate group, intramedullary nail group and traction group. The length of hospital stay in the traction groupwas significantly longer than that of the plate group and the intramedullary nail group. The total treatment cost of the tractiongroup was significantly less than that of the plate group, intramedullary nail group and external fixation group, and the differencewas statistically significant(P<0.05).Conclusion The choice of surgical methods for children’s femoral shaft fractures is moreinclined to minimally invasive techniques, and intramedullary nail internal fixation has replaced plate internal fixation as thefirst

关 键 词：儿童股骨干骨折 髓内钉 钢板 外固定架 牵引 

分 类 号：R687.3[医药卫生—骨科学]