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目的探讨单侧多功能外固定器在儿童骨折治疗中的适应证、使用方法及应用价值。方法回顾性分析1999年1月～2004年12月107例儿童骨折的治疗,男72例,女35例,年龄0.5～14岁,平均7.6岁。其中股骨干骨折63例(4例为双侧股骨干骨折),胫骨骨折26例(其中15例合并腓骨骨折),骨盆骨折11例(均为骨盆环两处以上的不稳定型骨盆骨折),肱骨骨折7例。致伤原因:车祸63例,跌落伤22例,砸伤9例,其他13例。107例患儿中89例闭合骨折,18例开放骨折。均采用单臂多功能外固定器固定治疗。术后随访观察骨折愈合情况及并发症,术后6～14周拆除外固定器。随访时间3～44个月(平均19个月)。结果本组患儿骨折全部愈合,所有病例术后2～3周均出现骨痂,4～5周后骨痂生长良好。术后4～10周均达到临床愈合标准,无延迟愈合或不愈合、无严重并发症的发生。8例出现针道感染(7.5%)。3例固定针松动(2.8%),1例术后再骨折(0.9%),1例术后1周拍片发现骨折端移位,二次调整外固定器重新固定。结论单侧多功能外固定器固定术具有手术操作简单、创伤小、适应证广、固定可靠、并发症少、便于搬动和护理、不损伤骨膜,保留完整骨折处血肿、手术瘢痕小、可门诊拆除外同定免去再次手术等优点,是治疗儿童长骨干骨折、不稳定性骨盆骨折的有效方法之一,内收型骨盆骨折、开放性长骨骨折、粉碎性长骨骨折和骨干骨折并发多发伤患儿尤为适用,可为首选。
Objective To investigate the indications, methods of use and application of unilateral multifunctional external fixators in the treatment of children fracture. Methods Retrospective analysis of 107 cases of children fracture treatment from January 1999 to December 2004, 72 males and 35 females, aged 0.5 to 14 years, with an average of 7.6 years. There were 63 cases of femoral shaft fractures (4 cases of bilateral femoral shaft fractures), 26 cases of tibial fractures (15 cases with fibula fracture), 11 cases of pelvic fractures (2 cases of unstable pelvic fractures of the pelvic ring) Humerus fractures in 7 cases. Cause of injury: 63 cases of car accident, fall injury in 22 cases, 9 cases of bruising, the other 13 cases. Of the 107 children, 89 had closed fractures and 18 had open fractures. Are using one-arm multi-function external fixator treatment. Postoperative follow-up observation of fracture healing and complications, 6-14 weeks after removal of external fixator. Follow-up time of 3 to 44 months (mean 19 months). Results All the fractures healed in this group. All cases showed callus 2 to 3 weeks after operation, and callus grew well after 4 to 5 weeks. After 4 to 10 weeks to achieve clinical healing standards, no delayed healing or non-healing, no serious complications. 8 cases of needle infection (7.5%). Three cases were loosely fixed (2.8%), one was reoperated (0.9%). One case was found to have displaced the fracture by filming one week after operation. The external fixator was re-adjusted by the second adjustment. Conclusion The unilateral multifunctional external fixator has the advantages of simple operation, small trauma, wide indications, reliable fixation, few complications, easy to move and care, no damage to periosteum, Out-patient demolition with the same set to remove the advantages of re-operation, is the treatment of children with long bone fracture, unstable pelvic fracture is an effective method, adduction-type pelvic fracture, open long bone fracture, comminuted long bone fracture and fracture complicated by multiple injuries Especially suitable for children, may be the first choice.