患肢皮牵引辅助手法整复夹板外固定治疗小儿股骨干骨折  

Manipulative reduction and splint external fixation assisted with skin traction of affected limb for treatment of femoral shaft fracture in children

作　　者：刘巍[1] 陈小龙 张浩泉 LIU Wei;CHEN Xiao-long;ZHANG Hao-quan(Dept of Orthopaedics,the TCM Hospital of Taihe County,Fuyang,Anhui 236600,China)

机构地区：[1]太和县中医院骨科,安徽阜阳236600

出　　处：《临床骨科杂志》2023年第2期270-275,共6页Journal of Clinical Orthopaedics

摘　　要：目的 探讨患肢皮牵引辅助手法整复夹板外固定治疗小儿股骨干骨折的疗效。方法 将126例股骨干骨折患儿根据治疗方法不同分为对照组(63例,采用弹性髓内钉固定治疗)和观察组(63例,采用患肢皮牵引辅助手法整复夹板外固定治疗)。比较两组治疗费用、骨折愈合时间、患肢负重情况、膝关节活动度(屈曲、伸直)、并发症发生情况以及临床疗效。结果 患儿均获得随访,时间6~12(8.26±1.47)个月。总治疗费用、固定材料费用、扶拐行走时间、完全负重时间、骨折愈合时间观察组均少(短)于对照组(P<0.05)。扶拐负重时间两组比较差异无统计学意义(P>0.05)。并发症发生率观察组低于对照组(P<0.05)。末次随访时,膝关节伸直、屈曲活动度观察组均优于对照组(P<0.05),Kolmert评分优良率观察组明显高于对照组(P<0.05)。结论 患肢皮牵引辅助手法整复夹板外固定治疗小儿股骨干骨折效果满意,同时该方法操作简单、并发症少、治疗费用低,特别适合在基层医院开展。Objective To investigate the effect of skin traction assisted manipulative reduction and splint external fixation in the treatment of femoral shaft fractures in children.Methods The 126 cases of femoral shaft fractures were divided into control group(63 cases,treated with elastic intramedullary nail fixation)and observation group(63 cases,treated with external splint fixation assisted by skin traction),according to different treatment methods.The treatment cost,fracture healing time,weight-bearing of affected limb,range of motion of knee joint(flexion,extension),complications and clinical efficacy were compared between the two groups.Results All patients were followed up for 6~12(8.26±1.47)months.The total treatment cost,fixed material cost,walking time with crutches,full weight-bearing time and fracture healing time in the observation group were less(shorter)than those in the control group(P<0.05),and walking time with crutches weight-bearing had no difference between two groups(P>0.05).The incidence rate of complications in the observation group was lower than that in the control group(P<0.05).At the last follow-up,the satisfaction of knee extension and flexion in the observation group were better than the control group(P<0.05),and the excellent and good rate of Kolmert score in the observation group was significantly higher than that in the control group(P<0.05).Conclusions Manipulative reduction combined with splint external fixation in the treatment of femoral shaft fractures in children has satisfactory effect,with simple operation,few complications and low cost,which is especially suitable for primary hospital.

关 键 词：股骨干骨折 手法整复 夹板外固定 皮牵引 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]