论文部分内容阅读
目的评价Ender钉髓内固定治疗小儿下肢长干骨骨折的疗效。方法自2003年2月至今我院采用Ender钉治疗小儿下肢骨折40例。男31例,女9例,年龄3.8~15岁(平均7.8岁)。股骨分离骨折33例(中1/3骨折22例、远1/3骨折3例,近1/3骨折8例),胫腓骨双骨折7例,4例是开放性损伤。术后所有病例均进行了平均13.5个月(2~23个月)的随访。28例得到了1年以上的随访,将继续观察肢体长短的问题。临床上观察了患儿的髋膝关节活动以及步态情况。结果所有病例骨折处均获得Ⅰ期愈合。有5例在骨折断端有前后或侧位片上不超过6°成角。39例术后髋膝关节活动正常,1例膝关节屈曲受限。本组病例术后无感染、骨不连、Ender钉折断、骨骺损伤等并发症。现已有18例术后半年行内固定取出并在继续随访中。结论弹性Ender钉髓内固定治疗儿童闭合复位困难的股骨骨折和粉碎性胫骨骨折有效,适用于4~15岁儿童股骨干骨折、胫骨骨折。具有手术切口小、软组织损伤少、不破坏骨膜、手术时间短、不需输血、并发症少等特点。
Objective To evaluate the efficacy of Ender nail fixation in the treatment of long bone fracture of lower extremities in children. Methods From February 2003 to now, 40 cases of pediatric lower extremity fractures were treated with Ender nail in our hospital. 31 males and 9 females, aged 3.8 to 15 years (mean, 7.8 years). 33 cases of femoral fractures (22 cases in 1/3 of fractures, 3 cases of far 1/3, nearly 1/3 of fractures), 7 cases of tibiofibular fractures, 4 cases of open injury. All cases were followed up for an average of 13.5 months (2 to 23 months). 28 cases were followed for more than 1 year, will continue to observe the problem of limb length. Clinically observed in children with hip and knee activities and gait situation. Results All the cases were fractured at the first phase of healing. There are 5 cases of fractures in the anteroposterior or lateral radiographs do not exceed 6 ° angulation. Thirty-nine patients had normal knee activity and one knee flexion was limited. This group of patients without infection, nonunion, Ender nail fracture, epiphyseal injury and other complications. Now 18 cases of six months after the line was removed and continued follow-up. Conclusion Flexible Ender nailing is effective in the treatment of femoral fractures and comminuted tibial fractures that are difficult to be closed and closed in children. It is suitable for femoral shaft fractures and tibial fractures in children aged 4-15 years old. With a small incision, less soft tissue damage, does not destroy the periosteum, the operation time is short, no blood transfusion, fewer complications.