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保守与微创手术治疗小儿转子下骨折的放射学及临床疗效对比
Hits: 2267   Download times: 1450   Received:February 03, 2009    
作者Author单位UnitE-Mail
蔡攀 CAI Pan 温州医学院附属第二医院骨科,浙江 温州 325027 Department of Orthopaedics,the 2nd Affiliated Hospital of Medical College of Wenzhou,Wenzhou 325027,Zhejiang,China  
陆燕 LU Yan 上海市第九人民医院周浦分院检验科  
杨雷 YANG Lei 温州医学院附属第二医院骨科,浙江 温州 325027 Department of Orthopaedics,the 2nd Affiliated Hospital of Medical College of Wenzhou,Wenzhou 325027,Zhejiang,China  
王志强 WANG Zhi-qiang 温州医学院附属第二医院骨科,浙江 温州 325027 Department of Orthopaedics,the 2nd Affiliated Hospital of Medical College of Wenzhou,Wenzhou 325027,Zhejiang,China  
期刊信息:《中国骨伤》2009年22卷,第7期,第508-511页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:比较小儿股骨转子下骨折保守与微创手术治疗的放射学结果及临床疗效。

方法: 45例股骨转子下骨折患者,男28例,女17例;年龄4~15岁,平均11.6岁,分别采用皮或骨牵引加髋“人”字石膏治疗(16例)及闭合复位弹性髓内钉固定(29例).

结果:随访26~62个月,平均39.5个月,45例骨折均愈合。早期放射学(治疗后4周)结果Beaty评分:保守组满意6例(37.50%),微创手术组满意26例(89.66%).晚期放射学(治疗后2年)结果Theologis评分:保守组满意11例(62.50%),微创手术组满意28例(96.55%).髋关节功能Sanders评分:保守组优12例,良4例;微创手术组优28例,良1例。上述差异均有统计学意义(P<0.05).

结论:微创手术治疗比保守治疗能获得更满意骨折对位及对线,可作为治疗小儿转子下骨折的首选方法。
[关键词]:股骨  转子下骨折  外科手术,微创性  保守治疗
 
Comparison of results of radiology and clinical effect with methods of the nonoperative and minimally invasive operation in treating femoral subtrochanteric fractures in children
Abstract:

Objective: To compare the radiographic and functional outcomes of nonoperative and minimally invasive methods in treating femoral subtrochanteric fractures in children.

Methods: Forty-five children(male 28,female 17)aging from 4 to 15 years old with femoral subtrochanteric fracture were managed with traction and cast application(16 cases),and elastic intramedullary nailing(29 cases). Early and late radiologic outcomes were respectively evaluated by Beaty and Theologis criteria. The outcomes of clinical effect were evaluated with Sanders scoring system.

Results: Al1 patients were followed up from 26 to 62 months with an average of 39.5 months. The fractures united in 45 patients. Early(at 4th week after treatment)satisfactory radiologic outcomes were respectively 6 cases and 26 cases between two methods of nonoperative and minimally invasive. Late (at 2nd year after treatment) satisfactory radiologic outcomes were respectively 11 cases and 28 cases between two methods of nonoperative and minimally invasive. According to Sanders scoring,12 cases were excellent,4 good with nonoperative methods;and 28 excellent,1 good with minimally invasive methods. There were significant differences between the two groups in aforesaid aspect.

Conclusion: Minimally invasive methods provided more satisfactory alignment of fractures as well as better functional outcomes than nonoperative methods. It is the first choice to treat femoral subtrochanteric fractures in children.
KEYWORDS:Femur  Subtrochanteric fractures  Surgical procedures,minimally invasive  Conservative treatment
 
引用本文,请按以下格式著录参考文献:
中文格式:蔡攀,陆燕,杨雷,王志强.保守与微创手术治疗小儿转子下骨折的放射学及临床疗效对比[J].中国骨伤,2009,22(7):508~511
英文格式:CAI Pan,LU Yan,YANG Lei,WANG Zhi-qiang.Comparison of results of radiology and clinical effect with methods of the nonoperative and minimally invasive operation in treating femoral subtrochanteric fractures in children[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(7):508~511
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