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目的:观察并比较弹性髓内钉(ESIN)与钢板固定(PF)治疗儿童股骨干中段骨折的临床疗效。方法:选择2013年2月至2016年12月我院收治的股骨干中段骨折患儿90例,依据治疗方法不同分为ESIN组和PF组。ESIN组(n=45)采用弹性髓内钉固定,PF组(n=45)采用钢板固定,比较两组患者手术时间、手术切口、术中失血量、术后切口引流量等手术指标,随访评估患者住院时间、完全负重时间、骨折愈合时间;按Flynn评定标准比较两组患者的最终治疗结果。结果:两组患者术中失血量、术后引流量比较差异无统计学意义(P>0.05),ESIN组患者手术切口显著小于PF组(P<0.05),手术时间、透视时间、完全负重时间均显著短于PF组(P<0.05),临床疗效明显优于PF组(P<0.05)。结论:与钢板固定比较,弹性髓内钉在手术时间、透视时间显著短于钢板固定,临床疗效明显优于钢板固定,可作为儿童股骨干骨折内固定的首选材料。
Objective: To observe and compare the clinical efficacy of elastic intramedullary nails (ESIN) and plate fixation (PF) in the treatment of middle femoral shaft fractures in children. Methods: Ninety children with middle femoral shaft fractures admitted from February 2013 to December 2016 in our hospital were divided into ESIN group and PF group according to different treatment methods. The ESIN group (n = 45) was fixed with elastic intramedullary nails and the PF group (n = 45) was fixed with steel plate. Surgical indexes such as operative time, surgical incision, intraoperative blood loss and postoperative incision drainage were compared between the two groups The hospitalization time, complete weight-bearing time and fracture healing time were evaluated. The final treatment outcome was compared between two groups according to Flynn assessment criteria. Results: There was no significant difference between the two groups in the amount of blood loss and postoperative drainage (P> 0.05). The surgical incision in ESIN group was significantly smaller than that in PF group (P <0.05). The operative time, fluoroscopy time, Were significantly shorter than PF group (P <0.05), clinical efficacy was significantly better than the PF group (P <0.05). CONCLUSIONS: Compared with plate fixation, the time of operation and the fluoroscopy time are shorter than those of plate fixation. The clinical effect is obviously better than that of plate fixation. It can be used as the material of choice for internal fixation of femoral shaft fractures in children.