CAJ | 학술논문

目的探讨钛制弹性髓内钉(TEIN)固定治疗儿童股骨干长螺旋形骨折的疗效.方法回顾性分析2010年8月至2012年6月收治的18例儿童股骨干长螺旋形骨折患者资料,男13例,女5例;年龄为2岁2个月至6岁,平均3.5岁;骨折类型均为长螺旋形骨折.所有患者均采用闭合复位,在C型臂X线机监视下逆行穿入TEIN内固定.术后石膏或支具固定4周,4周后开始配戴支具进行不负重功能锻炼. 结果 18例患儿术后获平均13个月(9～ 20个月)随访.骨折愈合时间为3～5个月,平均3.5个月.末次随访时按照Flynn等提出的弹性髓内钉治疗股骨骨折的疗效标准评定疗效:优17例,良1例.5例患儿钉尾刺激皮肤出现过敏“激惹”现象,拔除TEIN后迅速愈合;1例患儿患肢较对侧下肢长1.1 cm.所有患者未发生骨髓炎、骨折延迟愈合或不愈合、断钉、钉脱出及骨骺损伤等并发症. 结论 TEIN固定治疗儿童股骨干长螺旋形骨折具有创伤小、不损伤骨骺、骨折愈合良好、患肢功能恢复快及并发症少等优点,是一种有效、可靠的方法.
목적 탐토태제탄성수내정(TEIN)고정치료인동고골간장라선형골절적료효.방법 회고성분석2010년8월지2012년6월수치적18례인동고골간장라선형골절환자자료,남13례,녀5례;년령위2세2개월지6세,평균3.5세;골절류형균위장라선형골절.소유환자균채용폐합복위,재C형비X선궤감시하역행천입TEIN내고정.술후석고혹지구고정4주,4주후개시배대지구진행불부중공능단련. 결과 18례환인술후획평균13개월(9～ 20개월)수방.골절유합시간위3～5개월,평균3.5개월.말차수방시안조Flynn등제출적탄성수내정치료고골골절적료효표준평정료효:우17례,량1례.5례환인정미자격피부출현과민“격야”현상,발제TEIN후신속유합;1례환인환지교대측하지장1.1 cm.소유환자미발생골수염、골절연지유합혹불유합、단정、정탈출급골후손상등병발증. 결론 TEIN고정치료인동고골간장라선형골절구유창상소、불손상골후、골절유합량호、환지공능회복쾌급병발증소등우점,시일충유효、가고적방법.
Objective To report titanium elastic intramedullary nailing (TEIN) for femoral long spiral fractures in children.Methods From August 2010 to June 2012,18 children with femoral long spiral fracture were treated in our department.They were 13 boys and 5 girls,aged from 2 years and 2 months to 6 years (average,3.5 years).Fractures were reduced closely and fixated with retrograde TEIN under C-arm fluoroscopy.Functional rehabilitation with cast was enforced for another 2 to 4 weeks after external fixation with plaster or brace for 4 weeks.Results The 18 cases were followed up for an average of 13 months (from 9 to 20 months).Their fractures healed after 3 to 5 months (average,3.5 months).According to the evaluation criteria proposed by Flynn for TEIN of femoral fractures,17 cases were rated as excellent and one as fine at the last follow-up.Five cases reported nail site irritation which was relieved after removal of the nails.One patient showed a longer length (1.1 cm) of the affected leg compared with the normal one.No infection,delayed union,nonunion,broken nail,or injury to the femoral or tibial epiphysis was reported.Conclusion Treatment of the femoral long spiral fractures in children with TEIN is effective and reliable,because of minimal invasion,no interference with the epiphysis,quick functional recovery and limited complications.