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目的探讨锁定加压钢板与克氏针治疗大龄儿童股骨远端粉碎骨折的疗效。方法2010年1月—2015年1月手术治疗儿童股骨远端粉碎骨折82例,其中锁定加压钢板固定42例,克氏针固定40例。男46例,女36例;年龄11~15.7岁,平均13.5岁;左侧43例、右侧39例;致伤原因为车祸62例,摔伤20例。按照HSS膝关节功能评分标准评定疗效,随访锁定加压钢板组与克氏针组的骨折再移位率及优良率,并进行统计学比较。结果所有患儿均获随访,随访时间12~40个月,平均36个月。锁定加压钢板组有1例再移位,再移位率为2.4%;克氏针组有4例再移位,再移位率为20%,差异有统计学意义(P<0.05);二组HSS膝关节功能评分,锁定加压钢板组优良率为90.5%,克氏针组优良率为60%,差异有统计学意义(P<0.05)。结论对于大龄儿童股骨远端粉碎骨折应用锁定加压钢板具有复位良好,固定牢靠,骨折再移位率低,有利于关节早期功能练习,膝关节功能良好等优点,是一种有效的内固定方法。
Objective To investigate the curative effect of locked compression plate and Kirschner wire in the treatment of comminuted distal femur fractures in older children. Methods From January 2010 to January 2015, 82 cases of distal comminuted fracture of femur were surgically treated in our hospital. Of them, 42 cases were locked with compression plate and 40 cases were treated with Kirschner wire. 46 males and 36 females; aged 11 to 15.7 years, mean 13.5 years; 43 on the left and 39 on the right; the cause of injury was a car accident in 62 cases and a fall in 20 cases. The curative effect was assessed according to the HSS knee function score. The rate of fracture relocation and the rate of excellent and good fractures of the compression plate group and the Kirschner wire group were followed up and compared statistically. Results All children were followed up for 12 to 40 months with an average of 36 months. One case of locking compression plate group was re - displaced and the rate of re - displacement was 2.4%. Four cases were re - displaced in Kirschner wire group and the rate of re - displacement was 20%. The difference was statistically significant (P <0.05). The scores of HSS knee joint function in the two groups were 90.5% in locking compression plate group and 60% in Kirschner wire group, with significant difference (P <0.05). Conclusions For elderly children with distal comminuted fracture of the femur, the application of locking compression plate is an effective method of internal fixation with the advantages of good reduction, firm fixation, low re-displacement rate of fractures, early functional exercises and good knee joint function .