| 弹性髓内钉与微创锁定钢板治疗大龄儿童股骨粗隆下骨折的病例对照研究 |
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投稿时间：2013-09-15
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| 期刊信息：《中国骨伤》2013年，第26卷，第12期，第985-988页 |
| DOI：10.3969/j.issn.1003-0034.2013.12.004 |
| 基金项目: |
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中文摘要:
目的：探讨大龄儿童股骨粗隆下骨折的最佳的手术固定方式.
方法：回顾性分析2010年1月至2012年1月36例大龄儿童股骨粗隆下骨折的病例资料，18例行弹性髓内钉固定（弹性髓内钉组），男11例，女7例，年龄7～13岁，平均9.4岁，骨折按Seinsheimer分型：ⅡA型4例，ⅡB型3例，ⅡC型2例，ⅢA型4例，ⅢB型3例；18例行微创锁定加压钢板固定治疗（钢板固定组），男10例，女8例，年龄8～13岁，平均9.6岁，骨折按Seinsheimer分型：ⅡA型3例，ⅡB型4例，ⅡC型3例，ⅢA型4例，ⅢB型2例，Ⅳ型2例.观察并记录两组患者骨折愈合时间、术后并发症（包括伤口感染、内同定物失效或断裂、矢状面成角畸形、髋内翻畸形等）、髋关节功能的恢复情况.
结果：所有患儿术后随访15～36个月，平均21个月.骨折均获愈合，愈合时间7～16周，平均9.5周.弹性髓内钉组术后复查有3例患儿出现轻度矢状面成角畸形、髋内翻畸形3例，肢体缩短2例，钢板固定组未发生切口感染、内同定物失效或断裂，有1例患儿术后复查有轻度矢状面成角，无髋内翻、肢体短缩等畸形.所有患儿随访中未发现骨骺损伤早闭、股骨头缺血性坏死.疗效评价采用Sanders标准：钢板固定组优14例，良3例；弹性髓内钉组优9例，良4例.术后髋关节功能恢复及并发症发生两组间比较差异有统计学意义.
结论：微创锁定钢板固定治疗大龄儿童股骨粗隆下骨折的临床疗效优于TEN法，具有固定更为牢靠、并发症少等优点. |
| 【关键词】股骨骨折 骨折同定术,髓内 钢板,外科 |
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| Comparing clinical effects of titanic elastic nail and locking compression pine fixation in treating subtrochanteric fractures in older children |
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ABSTRACT
Objective: To explore optimal choice of surgical treatment for subtrochanteric fractures in older children.
Methods: A retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them,18 patients(11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail(TEN) fixation,4 cases were Type ⅡA,3 cases were ⅡB,2 cases were ⅡC,4 cases were ⅢA,3 cases were ⅢB according to Seinsheimer classification. Eighteen patients(10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine(LCP) fixation,and 3 cases were Type ⅡA,4 cases were ⅡB,3 cases were ⅡC,4 cases were ⅢA,2 cases were ⅢB. Fracture healing time,postoperative complications(including wound infection,failure and breakage of internal fixtion,deformities of angular on the sagittal view,deformities of coxa vara) and recovery of hip joint function were observed and recorded.
Results: All children were followed up from 15 to 36 months with an average of 21. Fracture were all healed,the time ranged from 7 to 16 weeks(mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view,3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening;while 1 case occurred mild deformities of angular on the sagittal view,and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury,avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard,14 cases got excellent results,3 cases were moderate in LCP group,while 9 cases in excellent,4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications.
Conclusion: For the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation,which has advantages of reliable fixation,and less complications. |
| KEY WORDS Femoral fractures Fracture fixation, intramedullary Plate, surgical |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 朱康祥,尹善青.弹性髓内钉与微创锁定钢板治疗大龄儿童股骨粗隆下骨折的病例对照研究[J].中国骨伤,2013,26(12):985~988 |
| 英文格式: | ZHU Kang-xiang,YIN Shan-qing.Comparing clinical effects of titanic elastic nail and locking compression pine fixation in treating subtrochanteric fractures in older children[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(12):985~988 |
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