闭合复位经皮弹性髓内针治疗儿童股骨干骨折(1)
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【摘要】 目的 评价闭合复位经皮弹性髓内针治疗儿童股骨干骨折的临床效果，并分析并发症的发生原因。方法 回顾性分析本院2006年3月至2010年8月经闭合复位弹性髓内针治疗的儿童股骨干骨折22例，其中男10例，女12例。进行规律随访并拍摄X线片观察骨折愈合情况。结果 所有病例均获的随访，平均随访8.2个月。所有骨折均愈合，平均愈合时间为10.4周。参照Flynn提出的髓内针治疗骨折的评分标准：末次随访时优14例，良8例，优良率100%。结论 闭合复位经皮弹性髓内针是治疗儿童股骨干骨折的一种有效方法，具有损伤小、不干扰骨折局部血运、不损伤骨骺、应力遮挡小、患肢功能恢复快及并发症少等优点。
【关键词】
弹性髓内针；儿童；股骨干骨折
Elastic stable intramedullary nailing per cutem after closed reduction in treating femoral shaft fractures in children
WANG Hailong.The People’s Hospital of Gejiu City of Yunan Province,Yunan 661000,China
【Abstract】 Objective
To evaluate the clinical effect of elastic stable intramedullary nail fixation per cutem after closed reduction for femoral shaft fractures in children, and to analyze the postoperative complications. Methods During March 2006 and August 2010, 22 cases underwent elastic stable intramedullary nail fixation per cutem after closed reduction in our hospital, 10 cases were male and 12 cases were female. All patients were followed up and taken Xray films to observe the union of the fractures. Results All patients were followed up and the average 8.2 months. All the fractures were cured with a mean 10.4 weeks. According to Flynn criteria，the results were excellent in 14 cases，good in 8 cases，and the rate of excellent and good was 100%. Conclusion Elastic stable intramedullary nailing per cutem after closed reduction is an effective therapeutic approach for femoral shaft fractures in children. It has advantages such as minimal invasion, not affect the blood supply of the fracture bone, not damage the epiphyseal plate, low stress shielding, short time recovery for the affected extremity, few complications and so on.
【Key words】
Elastic stable intramedullary nailing;Child;Femoral shaft fractures
作者单位：661000云南省个旧市人民医院
股骨干骨折是儿童常见骨折，占儿童骨损伤的1.6%，发病率为1/5000,男女发病比率为2.6∶1[1]。既往对儿童股骨干骨折的常规治疗是髋人字石膏或牵引加髋人字石膏固定。但保守治疗时间长、骨折对位差、下地时间晚，患肢功能恢复差。自1980年法国Nancy医院发明弹性髓内针(Elastic Stable Intramedullary Nail, ESIN) 以来的近30年间[2]，弹性髓内针以其明显的优越性而被广泛接受，应用于包括股骨在内的儿童长管骨骨折。本院从2006年起至今应用钛质弹性髓内针技术闭合复位经皮治疗儿童股骨干骨折22例，取得了良好的疗效。复习文献并结合自身经验，报告如下。
1 资料与方法
1.1 一般资料 自2006年3月至2010年8月，共治疗22例儿童股骨干骨折。患儿平均年龄7.7岁(3~14岁)，男10例，女12例；左腿12例，右腿10例。受伤类型：交通伤16例，坠落伤2例，重物砸伤4例。开放损伤2例(Gustilo I)，其中一例合并有同侧膝部外侧挫裂伤伴腓总神经损伤 ......
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