两种方法治疗学龄期儿童股骨下段不稳定型骨折的疗效比较  

Comparison effect of two methods for treatment of unstable distal femoral fractures in school-age children

作　　者：张远鉴 王意菊 尹同珍[1] 王树辉[1] ZHANG Yuan-jian;WANG Yi-ju;YIN Tong-zhen;WANG Shu-hui(Dept of Pediatric Orthopaedics and Bone Oncology,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital of Hebei Province,Cangzhou,Hebei 061000,China)

机构地区：[1]河北省沧州中西医结合医院小儿骨科、骨肿瘤科,河北沧州061000 [2]河北省沧州中西医结合医院骨科,河北沧州061000

出　　处：《临床骨科杂志》2024年第1期92-96,共5页Journal of Clinical Orthopaedics

基　　金：河北省卫健委医学科学研究课题计划(编号:20200616)。

摘　　要：目的比较股骨远端90°锁定钢板与弹性髓内钉治疗学龄期儿童股骨下段不稳定型骨折的疗效。方法采用随机数字表法将75例学龄期股骨下段不稳定型骨折患儿分成观察组(采用股骨远端90°锁定钢板治疗,38例)与对照组(采用闭合或切开复位弹性髓内钉治疗,37例)。记录手术情况、骨折复位及愈合情况、术后再移位发生率。采用HSS评分评价膝关节功能。结果患儿均获得随访,时间6~24个月。术中出血量、术中透视次数观察组均少于对照组(P<0.05)。术后3 d X线片显示两组骨折均复位良好。两组骨折愈合时间2.5~5个月。末次随访时,HSS评分优良率观察组高于对照组(P<0.05)。术后再移位发生率观察组低于对照组(P<0.05)。结论与弹性髓内钉相比,股骨远端90°锁定钢板治疗学龄期儿童股骨下段不稳定型骨折,术中出血量、透视次数更少,术后骨折再移位率更低,疗效更好。Objective To compare the efficacy of 90°locking plate of distal femur and elastic intramedullary nail in the treatment of unstable fracture of lower femur in school-age children.Methods The 75 school-age children with unstable fractures of lower femur were divided into observation group(38 cases were treated with 90°locking plate of distal femur)and control group(37 cases were treated with closed or open reduction elastic intramedullary nail)by random number table.The conditions of operation,fracture reduction and healing,and the incidence of postoperative re-displacement were recorded.The knee joint function was evaluated by HSS score.Results All patients were followed up for 6~24 months.Intraoperative blood loss and intraoperative fluoroscopy times in observation group were less than those in control group(P<0.05).Three days after the operation,X-ray films showed that the fractures in both groups were well reduced,and the healing time of the fractures in both groups was 2.5~5 months.At the last follow-up,the excellent-good rate of HSS score of observation group was higher than that of control group(P<0.05).The incidence rate of postoperative re-displacement in observation group was lower than that in control group(P<0.05).Conclusions Compared with elastic intramedullary nail,the 90°locking plate of lower femur has less intraoperative blood loss,fewer complications and better efficacy in the treatment of unstable fracture of the lower femur in school-age children.

关 键 词：股骨远端90°锁定钢板 弹性髓内钉 股骨下段骨折 儿童 

分 类 号：R726.834.2[医药卫生—儿科] R726.873.2[医药卫生—临床医学]