青少年专用型股骨髓内钉治疗大龄儿童及青少年股骨干骨折近期疗效观察  

Short-term effectiveness of expert adolescent lateral femoral nail fixation for femoral shaft fractures in older children and adolescents

作　　者：贺小张 王桃[1] 南国新 王俊东[1] 廖鹏 许绍林 余凯龙 HE Xiaozhang;WANG Tao;NAN Guoxin;WANG Jundong;LIAO Peng;XU Shaolin;YU Kailong(Department of Pediatric Surgery,Pingxiang People’s Hospital,Pingxiang Jiangxi,337000,P.R.China;Department of Pediatric Orthopedics,Municipal Children’s Hospital,Guangdong Medical University,Dongguan Guangdong,523326,P.R.China)

机构地区：[1]萍乡市人民医院小儿外科,江西萍乡337000 [2]广东医科大学东莞市儿童医院小儿骨科,广东东莞523326

出　　处：《中国修复重建外科杂志》2025年第3期290-295,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨应用青少年专用型股骨髓内钉(expert adolescent lateral femoral nail,EALFN)治疗大龄儿童及青少年股骨干骨折的近期疗效。方法回顾性分析2020年7月—2024年6月收治且符合选择标准的17例股骨干骨折患者临床资料,均骨折复位后应用EALFN固定。男11例,女6例;年龄11~16岁,平均13.3岁。体质量40~84 kg,平均51.2 kg;身高150~172 cm,平均162.1 cm。致伤原因:交通事故伤9例,高处坠落伤1例,摔伤7例。1例为开放性骨折外固定架固定后骨折延迟愈合,二期改髓内钉内固定;其余均为闭合性骨折,受伤至手术时间2~10 d,平均5.8 d。记录手术时间、术后住院时间。X线片复查骨折愈合情况,末次随访时测量双侧股骨长度、颈干角、股骨颈最宽径(widest femoral neck diameter,FND)、关节面转子间距(articular trochanteric distance,ATD);采用Harris评分评价髋关节功能。比较上述指标健、患侧差异。结果手术时间65~130 min,平均94.1 min;术后住院时间5~40 d,平均16.7 d。患者均获随访,随访时间7~36个月,平均14.4个月。其中1例随访时发现骨折愈合不满意,于术后6个月取出远端锁定钉行断端动力化后部分负重,骨折愈合,于术后24个月取出髓内钉。其余骨折均顺利愈合,愈合时间6~20个月,平均9.6个月;二次手术取出髓内钉。随访期间均未发生股骨再骨折、大转子发育异常及股骨头坏死等并发症。末次随访时,患侧与健侧股骨长度、FND、ATD、颈干角、髋关节Harris评分比较,差异均无统计学意义(P>0.05)。结论对于大龄儿童及青少年股骨干骨折,采用EALFN固定更符合髓内中心固定及加速康复理念,并发症少,近期疗效较好。Objective To investigate short-term effectiveness of using expert adolescent lateral femoral nail(EALFN)in treating femoral shaft fractures in older children and adolescents.Methods A retrospective analysis was conducted on the clinical data of 17 patients with femoral shaft fractures who met the inclusion criteria and were admitted between July 2020 and June 2024.All fractures were fixed with EALFN after reduction.There were 11 males and 6 females,with a mean age of 13.3 years(range,11-16 years).The average body weight was 51.2 kg(range,40-84 kg),and the average height was 162.1 cm(range,150-172 cm).The causes of injury included traffic accidents(n=9),falling from height(n=1),and simple falls(n=7).One patient had an open fracture treated with an external fixator and experienced delayed fracture healing.The remaining patients were closed fractures,with an average time from injury to operation of 5.8 days(range,2-10 days).Operation time and postoperative hospital stay were documented.During follow-up,X-ray films were taken to observe the fracture healing,and the bilateral femoral length,femoral neck-shaft angle,widest femoral neck diameter(FND),and articular trochanteric distance(ATD)were measured at last follow-up.Hip function was assessed using the Harris score.The differences in the all indicators between the healthy and affected sides were compared.Results The operation time ranged from 65 to 130 minutes(mean,94.1 minutes).Postoperative hospital stay ranged from 5 to 40 days(mean,16.7 days).All patients were followed up 7-36 months(mean,14.4 months).One patient exhibited delayed fracture healing during follow-up.The distal locking nail was removed at 6 months after operation,and partial weight-bearing was initiated following dynamic fracture stabilization.The fracture healing was achieved,and the intramedullary nail was removed at 24 months after operation.The other fractures healed with the healing time of 6-20 months(mean,9.6 months),and the intramedullary nails were removed.During follow-up,no femoral fract

关 键 词：股骨干骨折 青少年专用型股骨髓内钉 髓内中心固定 大龄儿童 青少年 

分 类 号：R68[医药卫生—骨科学]