中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
20期
9090-9093
,共4页
髋骨折%儿童%钛质弹性髓内钉%骨折内固定术
髖骨摺%兒童%鈦質彈性髓內釘%骨摺內固定術
관골절%인동%태질탄성수내정%골절내고정술
Hip fractures%Child%Titanium elastic nail%Internal facture fixation
目的：探讨采用钛质弹性髓内钉治疗儿童股骨转子周围骨折的临床疗效。方法回顾性分析我院2009年1月至2012年1月的儿童股骨骨折109例，以AO儿童长骨骨折分型为31-M/3.1的股骨转子间及分型为32-D/5.1的转子下骨折共17例（均为单侧），其中的13例患儿（男9例，女4例）接受了钛质弹性髓内钉内固定治疗，平均年龄4.2岁，平均体重15.3 kg。术后予以髋人字石膏固定6～8周，术后6～8个月拔除髓内钉。术后随访患儿的骨盆正位片、双侧髋关节活动范围、双侧股骨颈干角及双下肢长度，并予统计学分析。计算13例患儿重量指数并与正常标准曲线进行对比。结果所有患儿骨折均获得良好愈合，无一例出现股骨头缺血性坏死、骨不连、骺板早闭、髋内翻和患肢短缩等并发症。13例患儿的重量指数均位于同龄标准曲线的P50周围及其以下。对患、健侧髋关节活动度及颈干角的统计学分析结果示两者无显著性差异（P＞0.05）。结论采用钛质弹性髓内钉治疗小年龄、非肥胖儿童股骨转子周围骨折是一种安全有效的手术选择。
目的：探討採用鈦質彈性髓內釘治療兒童股骨轉子週圍骨摺的臨床療效。方法迴顧性分析我院2009年1月至2012年1月的兒童股骨骨摺109例，以AO兒童長骨骨摺分型為31-M/3.1的股骨轉子間及分型為32-D/5.1的轉子下骨摺共17例（均為單側），其中的13例患兒（男9例，女4例）接受瞭鈦質彈性髓內釘內固定治療，平均年齡4.2歲，平均體重15.3 kg。術後予以髖人字石膏固定6～8週，術後6～8箇月拔除髓內釘。術後隨訪患兒的骨盆正位片、雙側髖關節活動範圍、雙側股骨頸榦角及雙下肢長度，併予統計學分析。計算13例患兒重量指數併與正常標準麯線進行對比。結果所有患兒骨摺均穫得良好愈閤，無一例齣現股骨頭缺血性壞死、骨不連、骺闆早閉、髖內翻和患肢短縮等併髮癥。13例患兒的重量指數均位于同齡標準麯線的P50週圍及其以下。對患、健側髖關節活動度及頸榦角的統計學分析結果示兩者無顯著性差異（P＞0.05）。結論採用鈦質彈性髓內釘治療小年齡、非肥胖兒童股骨轉子週圍骨摺是一種安全有效的手術選擇。
목적：탐토채용태질탄성수내정치료인동고골전자주위골절적림상료효。방법회고성분석아원2009년1월지2012년1월적인동고골골절109례，이AO인동장골골절분형위31-M/3.1적고골전자간급분형위32-D/5.1적전자하골절공17례（균위단측），기중적13례환인（남9례，녀4례）접수료태질탄성수내정내고정치료，평균년령4.2세，평균체중15.3 kg。술후여이관인자석고고정6～8주，술후6～8개월발제수내정。술후수방환인적골분정위편、쌍측관관절활동범위、쌍측고골경간각급쌍하지장도，병여통계학분석。계산13례환인중량지수병여정상표준곡선진행대비。결과소유환인골절균획득량호유합，무일례출현고골두결혈성배사、골불련、후판조폐、관내번화환지단축등병발증。13례환인적중량지수균위우동령표준곡선적P50주위급기이하。대환、건측관관절활동도급경간각적통계학분석결과시량자무현저성차이（P＞0.05）。결론채용태질탄성수내정치료소년령、비비반인동고골전자주위골절시일충안전유효적수술선택。
Objective To evaluate the clinical efficacy of surgical management of pediatric intertrochanteric fractures by using Titanium Elastic Nail internal fixation. Methods In this retrospective study, there was a consecutive series of 109 cases of femoral fractures from Jan 2009 to Jan 2012 in our department. Of all these patients, there were 13 patients (9 male and 4 female), whose average age was 4.2 years old and average weight was 15.3 kg, with intertrochanteric fractures(AO's classification was 31-M/3.1 and 32-D/5.1) by using titanium elastic nail internal fixation for their treatment. All the 13 patient underwent a 6-8 weeks spica cast external fixation and intramedullary nails removal 6 to 8 months postoperatively. The follow-up contents include radiograph of pelvis, bilateral hip range of motion, bilateral femoral neck shaft angle and length of lower extremity,and the Ponderal Index of the patients were calculated and compared with standard PI curve. Results All the 13 patients had good bone heal. No major postoperative complications (such as osteonecrosis, coxa vara, epiphyseal plate closed early or discrepancy of lower extremity) were founded in this study. The 13 patients’ PI value was below the standard curve. There was no significant statistical difference between involved hip and uninvolved side hip in range of motion and femoral neck shaft angle(P>0.05). Conclusion Titanium elastic nail internal fixation is a safe and effective method in the treatment of young age and low weight pediatric intertrochanteric fracture patients.
