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[目的]通过测量术后随访X线片的股骨近端几何结构参数,了解经大转子进钉应用肱骨交锁髓内钉治疗青少年股骨干骨折对股骨近端发育的影响。[方法]回顾性分析2011年11月~2014年2月本科25例10~15周岁经大转子进钉应用肱骨交锁髓内钉治疗青少年股骨干骨折的患者,所有病例随访至至少骨性愈合,以健侧为对照组,收集最近一次随访的术后X线片,应用PACS处理软件测量其股骨近端几何结构参数,包括股骨近端颈干角(CDA)、关节面转子间距离(ATD)、转子间距(TTD)、关节面小转子间距(ALD)、股骨头中心至小转子距离(CSD)、股骨颈最宽径(FND)以及股骨头最宽径(FHD)。[结果]所有患儿均获得随访,平均年龄12.24岁,平均随访时间为25.6个月。术后X线片显示2例患者术后出现大转子骨骺吸收现象,患侧的股骨近端几何参数与健侧相比差异均无统计学意义。[结论]经大转子进钉应用肱骨交锁髓内钉治疗青少年股骨干骨折疗效满意,可以避免对股骨近端发育的影响。
[Objective] To investigate the effect of proximal humeral shaft fractures on the development of femoral proximal femoral shaft by means of trochanter nailing with humeral interlocking intramedullary nailing. [Methods] From November 2011 to February 2014, 25 under-aged patients aged 10 to 15 years who underwent trochanteric intramedullary nailing with trochanteric intramedullary nailing for treatment of adolescent femoral shaft fractures were retrospectively analyzed. All cases were followed up until at least the bony union . The contralateral X-ray films were collected at the latest follow-up. The proximal femoral geometric parameters including the proximal femoral neck angle (CDA), the distance between the articular surface and the intervertebral joints (ATD ), TTD, ALD, CSD, FND and FHD were measured. [Results] All children were followed up with a mean age of 12.24 years and a mean follow-up time of 25.6 months. The postoperative radiographs showed that the epiphysis of the greater trochanter occurred in 2 patients. There was no significant difference in the geometric parameters of the proximal femur compared with the contralateral ones. [Conclusion] The application of humeral interlocking intramedullary nailing via the greater trochanter nail in the treatment of adolescent femoral shaft fracture is effective and can avoid the influence on proximal femoral development.