中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2010年
1期
34-37
,共4页
潘骏%武垚森%易先宏%张敬东
潘駿%武垚森%易先宏%張敬東
반준%무요삼%역선굉%장경동
股骨骨折%骨折同定术,髓内%石膏,外科
股骨骨摺%骨摺同定術,髓內%石膏,外科
고골골절%골절동정술,수내%석고,외과
Femoral fractures%Fracture fixation,intramedullary%Casts,surgical
目的 比较弹性髓内钉(TEN)和石膏外同定治疗儿童股骨粗隆下骨折的临床疗效.方法 回顾分析30例儿童股骨粗隆下骨折的病例资料,其中14例行弹性髓内钉固定治疗(弹件髓内钉组),16例采用手法复位髋石膏固定(石膏固定组)治疗,记录骨折愈合时间及并发症,术后对两组患儿的影像学结果、髋关节功能进行比较分析.结果 所有患儿术后随访20～43个月,平均31个月.骨折均获愈合,愈合时间8～17周,平均10.5N.TEN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.所有患儿随访中均未发现有骨骺损伤早闭,股骨头缺血性坏死.石膏固定组术后复查有5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6例.早期结果按Beaty标准:TEN组满意率为92.9%,明显优于石膏固定组62.5%(P<0.01);晚期结果按Theologis标准:TEN组满意率为100%,石膏同定组81.3%,两组亦存在显著性差异(P<0.01).髋关节功能按Sanders标准:TEN组优12例,良1例,优良率:92.9%;石膏固定组优9例,良4例,优良率:81.4%,组间差异有统计学意义(P<0.05).结论 TEN固定治疗儿童股骨粗隆下骨折的临床疗效优于石膏固定法,它具有创伤小、操作简便、固定更为牢同、并发症少等优点,值得临床推广应用.
目的 比較彈性髓內釘(TEN)和石膏外同定治療兒童股骨粗隆下骨摺的臨床療效.方法 迴顧分析30例兒童股骨粗隆下骨摺的病例資料,其中14例行彈性髓內釘固定治療(彈件髓內釘組),16例採用手法複位髖石膏固定(石膏固定組)治療,記錄骨摺愈閤時間及併髮癥,術後對兩組患兒的影像學結果、髖關節功能進行比較分析.結果 所有患兒術後隨訪20～43箇月,平均31箇月.骨摺均穫愈閤,愈閤時間8～17週,平均10.5N.TEN組未髮生切口感染、內同定物失效或斷裂,有1例患兒術後複查有輕度矢狀麵成角,無髖內翻、肢體短縮等畸形.所有患兒隨訪中均未髮現有骨骺損傷早閉,股骨頭缺血性壞死.石膏固定組術後複查有5例患兒齣現輕度矢狀麵成角畸形,髖內翻畸形3例,肢體縮短6例.早期結果按Beaty標準:TEN組滿意率為92.9%,明顯優于石膏固定組62.5%(P<0.01);晚期結果按Theologis標準:TEN組滿意率為100%,石膏同定組81.3%,兩組亦存在顯著性差異(P<0.01).髖關節功能按Sanders標準:TEN組優12例,良1例,優良率:92.9%;石膏固定組優9例,良4例,優良率:81.4%,組間差異有統計學意義(P<0.05).結論 TEN固定治療兒童股骨粗隆下骨摺的臨床療效優于石膏固定法,它具有創傷小、操作簡便、固定更為牢同、併髮癥少等優點,值得臨床推廣應用.
목적 비교탄성수내정(TEN)화석고외동정치료인동고골조륭하골절적림상료효.방법 회고분석30례인동고골조륭하골절적병례자료,기중14례행탄성수내정고정치료(탄건수내정조),16례채용수법복위관석고고정(석고고정조)치료,기록골절유합시간급병발증,술후대량조환인적영상학결과、관관절공능진행비교분석.결과 소유환인술후수방20～43개월,평균31개월.골절균획유합,유합시간8～17주,평균10.5N.TEN조미발생절구감염、내동정물실효혹단렬,유1례환인술후복사유경도시상면성각,무관내번、지체단축등기형.소유환인수방중균미발현유골후손상조폐,고골두결혈성배사.석고고정조술후복사유5례환인출현경도시상면성각기형,관내번기형3례,지체축단6례.조기결과안Beaty표준:TEN조만의솔위92.9%,명현우우석고고정조62.5%(P<0.01);만기결과안Theologis표준:TEN조만의솔위100%,석고동정조81.3%,량조역존재현저성차이(P<0.01).관관절공능안Sanders표준:TEN조우12례,량1례,우량솔:92.9%;석고고정조우9례,량4례,우량솔:81.4%,조간차이유통계학의의(P<0.05).결론 TEN고정치료인동고골조륭하골절적림상료효우우석고고정법,타구유창상소、조작간편、고정경위뢰동、병발증소등우점,치득림상추엄응용.
Objective To compare the result of treatment with titanic elastic nail (TEN) and plaster fixation for subtrochanteric fractures in skeletally immature adolescents.Methods A retrospective review of 30 subtrochanteric fractures was carried out.In this series,14 patients were treated with TEN fixation and 16 had plaster immobilization.Early and late radiographic evaluation,joint function assessment were carried out.Results On average,the patients were followed up for 31 months(20-43 months).Bone union was accomplished in all patients.The mean time to union was 10.5 weeks,ranging from 8-17 weeks.One patient treated with TEN developed AP angulation.No other complication were detected in the TEN group.In the plaster immobilization group.there were 5 AP angulation,3 coxa vara and 6 limb shortening.According to the Beaty's grading,early percentage of good results is 92.9% in TEN group and 62.5% in the palster group(P<0.01):for late results according to the Theologis's standerd,TEN group's good rate is 1 00% and the plaster group is 81.3%(P<0.01).The joint function in 12 patients were good,1 fair aceording to the Sanders's standard in the TEN group,The total percentage of good and fair is 92.9%.The joint function in the plaster group was goo in 9 patients,fair in 4 patients.Together,these accounted for 91.4%of all cases(P<0.05).Conclusions TEN iS better than plaster fixation as a treatment of Subtrochanteric fractures in skeletally immature asolescents.
