文章摘要
屈继宁,马益善,李敏,吴永涛,汪兵,李云峰,苏菲,颉强.弹性髓内钉与接骨板内固定治疗儿童股骨转子下骨折的临床对照研究.骨科,2019,10(5):440-445
弹性髓内钉与接骨板内固定治疗儿童股骨转子下骨折的临床对照研究
Comparative study of elastic intramedullary nail and bone plate internal fixation in treatment of subtrochanteric fracture in children
投稿时间:2019-03-02  
DOI:10.3969/j.issn.1674-8573.2019.05.014
中文关键词: 儿童  股骨转子下骨折  弹性髓内钉  接骨板
英文关键词: Children  Subtrochanteric fracture of femur  Elastic intramedullary nail  Plate
基金项目:国家自然科学基金(81871743);陕西省自然科学基金(2017ZDJC-12)
作者单位E-mail
屈继宁 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054  
马益善 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054  
李敏 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054  
吴永涛 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054  
汪兵 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054  
李云峰 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054  
苏菲 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054  
颉强 西安交通大学医学院附属红会医院小儿骨科诊疗中心西安 710054 jiqiang@fmmu.edu.cn 
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中文摘要:
      目的 探讨弹性髓内钉与接骨板内固定治疗儿童股骨转子下骨折的临床疗效及相关优势。方法 回顾性分析2013年3月至2017年3月我院收治的100例股骨转子下骨折患儿,依据治疗方式的不同分成观察组(予以弹性髓内钉内固定术,50例)和对照组(予以接骨板内固定术,50例)。两组患儿术后均随访1年,比较两组患儿的手术时间、术中出血量、住院时间、骨折愈合时间及并发症的差异。采用Harris髋关节评分和美国特种外科医院(Hospital for Special Surgery,HSS)膝关节评分评定患肢髋、膝关节功能。结果 观察组术中出血量为(50.60±18.35) ml,住院时间为(6.75±4.40) d,骨折愈合时间为(56.50±3.85) d;对照组则分别为(55.30±18.95) ml、(6.80±5.75) d和(60.70±4.06) d,两组间上述指标的差异均无统计学意义(P>0.05)。两组病人在随访期内骨折全部愈合,对位对线良好,关节功能正常。观察组1例出现弹性钉针尾刺激皮肤现象,经二次手术剪短弹性钉尾端后症状消失,对照组出现切口脂肪液化1例,经重新缝合痊愈。结论 弹性髓内钉和接骨板内固定均为治疗儿童股骨转子下骨折的有效方法,两种方法各有优缺点,手术治疗原则是稳定与微创相结合,在恢复股骨轴线及长度的同时,注意对血运保护以利于骨折愈合。
英文摘要:
      Objective To investigate the clinical efficacy and related advantages of elastic intramedullary nail and bone plate internal fixation in the treatment of femoral subtrochanteric fracture in children. Methods A retrospective clinical control study was conducted to select 100 children with femoral subtrochanteric fractures from March 2013 to March 2017 in our hospital. The patients were divided into observation group (treated with elastic intramedullary nail internal fixation, 50 cases) and control group (treated with bone plate internal fixation, 50 cases) according to different treatment methods. Two groups of patients were followed up for one year after operation, and the differences in operation time, intraoperative blood loss, hospitalization time, fracture healing time, hip and knee joint function and complication between the two groups were compared. Harris hip score and Hospital for Special Surgery (HSS) knee score were used to evaluate the hip and knee function of affected limbs. Results The intraoperative blood loss in the observation group was (50.60±18.35) ml, the hospitalization time was (6.75±4.40) days, and the fracture healing time was (56.50±3.85) days, and those in the control group were (55.30±18.95) ml, (6.80±5.75) days and (60.70±4.06) days, respectively. There was no significant difference between the two groups (P>0.05). During the follow-up period, all patients in the two groups healed with good alignment and joint function. In the observation group, there was one case of skin irritation caused by elastic nail needle tail, and the symptoms disappeared after the tail end of elastic nail was cut short after the second operation. In the control group, there was one case of incision fat liquefaction, which was cured by re-suture. Conclusion Elastic intramedullary nail and bone plate internal fixation are both effective methods for the treatment of femoral subtrochanteric fractures in children. Both methods have their own advantages and disadvantages. The principle of surgical treatment is to combine stability with minimally invasive surgery. While restoring the femoral axis and length, attention should be paid to the protection of blood supply for fracture healing.
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