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目的比较弹性髓内针与钢板内固定治疗大年龄儿童(9-16岁)前臂双骨干骨折的疗效。方法 2008年至2010年35例我院收治的前臂双骨干骨折分为弹性髓内钉组和切开复位钢板螺钉固定组,根据术前情况和最终疗效(骨折愈合时间、前臂活动受限、桡骨弓恢复的情况、并发症情况)比较两组病例的一般资料、功能及并发症情况。结果髓内钉固定组21例,平均年龄12.5岁(9～14.6岁),钢板固定组14例,平均年龄14.5岁(10.9～16岁),两组在性别、受伤原因、骨折类型(AO)、是否开放骨折等方面差异无统计学意义;手术时间、止血带使用时间及出血量髓内钉组显著低于钢板固定组。两组在术后3月与6月时评价骨折愈合情况差异无统计学意义。最后一次随访时两组在前臂旋前旋后活动丢失上并无差异。并发症发生率两组差异无统计学意义。结论对于大龄儿童(9～16岁)的前臂骨干双骨折的手术治疗,与钢板内固定相比,弹性髓内钉固定同样为一安全有效的治疗方法。
Objective To compare the efficacy of elastic intramedullary nail and plate fixation in the treatment of forearm double-shaft fracture in children (9-16 years old) with large ages. Methods From 2008 to 2010, 35 cases of double-head forearm fracture treated in our hospital were divided into elastic nail group and open reduction screw fixation group. According to the preoperative situation and the final curative effect (fracture healing time, limited forearm activity, radius Bow recovery, complications) to compare the two groups of cases of general information, function and complications. Results There were 21 cases with intramedullary nail fixation, mean age was 12.5 years (range, 9 to 14.6 years), and plate fixation group was 14 years old (mean age 14.5 years, 10.9-16 years) , Whether the open fractures and other aspects of the difference was not statistically significant; operation time, tourniquet use time and bleeding volume was significantly lower than the nail plate fixation group. There was no significant difference in fracture healing between March and June after operation in both groups. At the last follow-up, there was no difference in loss of activity in the forearm pronation. The incidence of complications was no significant difference between the two groups. Conclusion Surgical treatment of double fractures of the forearm in elderly children (9-16 years old) is also a safe and effective method of treatment compared with internal fixation.