CAJ | 학술논문

目的比较小切口复位与闭合复位弹性钉固定儿童股骨干骨折的影像学结果及临床疗效.方法 2008年2月至2009年12月,收治68例年龄4～15岁的股骨骨折患儿,其中34例采用小切口复位弹性钉固定,男22例,女12例;年龄(8.2±2.5)岁;左侧10例,右侧24例;横形骨折18例,斜形12例,螺旋形4例.34例采用闭合复位弹性钉固定,男18例,女16例;年龄(8.6±2.6)岁;左侧14例,右侧20例;横形骨折15例,斜形14例,螺旋形5例.术前两组患儿一般资料具有可比性.分别对两组患儿手术时间、术中射线暴露时间及术后的影像学结果、临床疗效及并发症进行对比分析.结果与闭合复位弹性钉固定组相比,小切口复位组手术时间[(30.5±8.5) min vs.(53.0±15.0)min,P＜0.001]及术中放射线暴露时间[(28.4±18.5)s vs.(65.0±28.5)s,P＜0.001]明显缩短,两组差异有统计学意义.两组骨折愈合时间[(5.8±1.3)周vs.(5.7±1.4)周,P＞0.05]、完全负重时间[(10.5±2.5)周vs.(9.8±2.4)周,P＞0.05]及并发症发生率差异无统计学意义.根据弹性钉评分系统,小切口组优31例,良3例;闭合复位组优29例,良5例,两组影像学结果及临床疗效差异无统计学意义.结论小切口复位治疗儿童股骨骨折与闭合复位治疗的总体疗效相当,但小切口复位可以明显缩短手术时间及减少放射线暴露,可以作为闭合复位困难时的优先选择.
목적 비교소절구복위여폐합복위탄성정고정인동고골간골절적영상학결과급림상료효.방법 2008년2월지2009년12월,수치68례년령4～15세적고골골절환인,기중34례채용소절구복위탄성정고정,남22례,녀12례;년령(8.2±2.5)세;좌측10례,우측24례;횡형골절18례,사형12례,라선형4례.34례채용폐합복위탄성정고정,남18례,녀16례;년령(8.6±2.6)세;좌측14례,우측20례;횡형골절15례,사형14례,라선형5례.술전량조환인일반자료구유가비성.분별대량조환인수술시간、술중사선폭로시간급술후적영상학결과、림상료효급병발증진행대비분석.결과 여폐합복위탄성정고정조상비,소절구복위조수술시간[(30.5±8.5) min vs.(53.0±15.0)min,P＜0.001]급술중방사선폭로시간[(28.4±18.5)s vs.(65.0±28.5)s,P＜0.001]명현축단,량조차이유통계학의의.량조골절유합시간[(5.8±1.3)주vs.(5.7±1.4)주,P＞0.05]、완전부중시간[(10.5±2.5)주vs.(9.8±2.4)주,P＞0.05]급병발증발생솔차이무통계학의의.근거탄성정평분계통,소절구조우31례,량3례;폐합복위조우29례,량5례,량조영상학결과급림상료효차이무통계학의의.결론 소절구복위치료인동고골골절여폐합복위치료적총체료효상당,단소절구복위가이명현축단수술시간급감소방사선폭로,가이작위폐합복위곤난시적우선선택.
Objective To compare the radiological and clinical results in pediatric femoral shaft fractures treated with either mini-open reduction or closed reduction and titanium elastic nailing.Methods From February 2008 to December 2009,68 children with femoral shaft fractures were treated with a mini-open reduction and nail fixation (34 patients,22 males and 12 females,mean age of 8.2 ± 2.5 years) and closed reduction and nail fixation (34 patients,18 males and 16 females,mean age of 8.6 ± 2.6 years) respectively.Duration of operation and intraoperative fluoroscopy time were recorded in both groups.Clinical and radiological outcomes were assessed using the TEN scoring system.Results Both surgical and fluoroscopy time were significantly longer in closed reduction group.There were no significant differences between fracture healing time,full weight bearing time and complications.According to TEN Scoring System,mini-open reduction group was excellent in 31 cases,good in 3 cases.In closed reduction group,excellent was seen in 29 cases,good in 5 cases.There was no significant difference between the two groups in terms of clinical and radiological results.Conclusions Mini-open reduction provides the same satisfactory clinical results as closed reduction.It is an alternative method of closed reduction to prevent extensive intraoperative radiation exposure and to decrease the length of the surgical procedure.