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目的分析小儿骨不连临床特点,总结诊断与治疗经验。方法回顾性分析15例小儿骨不连患儿病历资料;诊断主要依据X线、CT等影像学检查技术,治疗方法主要为手术治疗。结果 X线平片:撕脱骨折块复杂性移位12例、单纯侧位移位3例;CT三维图像重建,无骨性连接10例、部分连接5例,骨折远端“鱼尾样”改变14例;自体骨髓复合人工骨联合骼骨骨膜移植术2例、带髓髓内钉治疗4例、外支架固定术治疗9例;平均随访时间(23±5)个月,8~16周骨愈合,末次随访均获得痊愈,无后遗症。结论小儿骨不连的诊断并不困难,手术是主要治疗手段,多数预后较好,但需长时间预防。
Objective To analyze the clinical features of pediatric nonunion and to summarize the diagnosis and treatment experience. Methods Retrospective analysis of 15 cases of pediatric nonunion children with medical records; diagnosis mainly based on X-ray, CT and other imaging techniques, the main treatment for surgical treatment. Results X-ray film: the fracture of the avulsion fracture complex shift in 12 cases, simple lateral displacement in 3 cases; three-dimensional CT reconstruction of the image, 10 cases without bone connection, partial connection in 5 cases, distal fracture "fish-like 2 cases were treated with autologous bone marrow combined artificial bone and iliac periosteum transplantation, 4 cases with intramedullary nailing and 9 cases with external fixation. The mean follow-up time was 23 ± 5 months, 16 weeks of bone healing, were recovered at the last follow-up, no sequelae. Conclusion The diagnosis of pediatric nonunion is not difficult. Surgery is the main treatment and most of the prognosis is good, but long-term prevention is needed.