CAJ | 학술논문

目的比较倒置LISS及弹性钉固定大龄儿童股骨转子下骨折的临床疗效及并发症.方法采用LISS倒置固定15例年龄9～15岁的股骨转子下骨折患儿(LISS组),并将其与同期进行、一般资料具有可比性,采用弹性钉固定治疗的26例患儿(TNE组)进行比较,对两组的手术指标、髋关节功能及并发症等进行分析.结果 LISS组平均随访时间30.5个月,TNE组平均随访36.2个月,两组骨折愈合时间、负重时间及住院时间差异无统计学意义,但手术时间LISS组(60.0±10.6)min长于TNE组(40.5±7.4)min、出血量LISS组(130.0±55.0)ml多于TNE组的(30.5±15.0)ml,住院费用LISS组(2.5±0.8)万元高于TNE组(1.2±0.5)万元,差异均有统计学意义；两组总并发症发生率无统计学差异,但LISS组切口疼痛发生率53.3,％(8/15)高于TNE组7.7％(2/26),TNE组对线不良发生率38.5％(10/26)高于LISS组的0％；髋关节功能Sanders评分LISS组平均58.20分,弹性钉组平均58.77分,差异无统计学意义.结论倒置LISS与弹性钉的总体临床疗效相当,应根据根据患儿体重、合并伤、骨折类型、软组织状况及家庭经济因素等综合考虑选择相应的固定方式.
목적 비교도치LISS급탄성정고정대령인동고골전자하골절적림상료효급병발증.방법 채용LISS도치고정15례년령9～15세적고골전자하골절환인(LISS조),병장기여동기진행、일반자료구유가비성,채용탄성정고정치료적26례환인(TNE조)진행비교,대량조적수술지표、관관절공능급병발증등진행분석.결과 LISS조평균수방시간30.5개월,TNE조평균수방36.2개월,량조골절유합시간、부중시간급주원시간차이무통계학의의,단수술시간LISS조(60.0±10.6)min장우TNE조(40.5±7.4)min、출혈량LISS조(130.0±55.0)ml다우TNE조적(30.5±15.0)ml,주원비용LISS조(2.5±0.8)만원고우TNE조(1.2±0.5)만원,차이균유통계학의의；량조총병발증발생솔무통계학차이,단LISS조절구동통발생솔53.3,％(8/15)고우TNE조7.7％(2/26),TNE조대선불량발생솔38.5％(10/26)고우LISS조적0％；관관절공능Sanders평분LISS조평균58.20분,탄성정조평균58.77분,차이무통계학의의.결론 도치LISS여탄성정적총체림상료효상당,응근거근거환인체중、합병상、골절류형、연조직상황급가정경제인소등종합고필선택상응적고정방식.
Objective To compare the complications and clinical outcome of reverse less invasive stabilization system (LISS) and elastic nailing for the treatment of subtrochanteric femur fractures in older children.Methods Fifteen children aged from 9 to 15 years old were admitted in this hospital for the treatment of subtrochanteric fractures.The 15 patients subtrochanteric fractures were fixed with reverse LISS.The other 26 patients,who underwent elastic nail fixation for the treatment of subtrochanteric fractures in the same period,were taken as controls.Operative indications,hip joint function and complications of these 2 groups were retrospectively analyzed.Results The average follow-up period of the patients was 30.5 months in LISS group,and 36.2 months in the elastic nail group.No significant difference between these 2 groups was found in fracture healing time,full weight-bearing time and average hospital stay.However,the patients of the LISS group had longer operation time (60.0 ± 10.6 min vs.40.5 ± 7.4 min,P＜0.05),less intraoperative blood loss (130.0 ± 55.0 ml vs.30.5 ± 15.0 ml,P＜0.05) and more hospital costs (25 000-± 800 RMB vs.12 000 ± 500 RMB,P＜0.05).The postoperative complication of these 2 groups was no statistically different,but the patients of the LISS group had a higher incidence of incisional pain,and the elastic nail group had a higher incidence of misalignment.Average Sanders hip function score of LISS group was not significantly different from that of elastic nail group (58.20 vs.58.77,P＞0.05).Conclusions The clinical outcome of LISS is comparable with elastic nailing for the treatment of subtrochanteric femur fractures in older children.The fixation device should be selected according to the associated injury,severity of soft tissue injuries and family economic status.