弹性髓内针治疗儿童四肢长管状骨骨折
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摘要
目的评价使用弹性髓内针固定儿童四肢长管状骨骨折的临床效果。方法通过对最近5年我院使用弹性髓内针治疗的儿童四肢长管状骨共146例进行分析总结,评价其固定效果、手术并发症、骨折愈合情况、肢体功能恢复情况。结果所有病例均获得6～12个月的随访,平均随访时间8.7个月。145例获得了骨折一期愈合,无血管、神经、肌腱损伤等并发症发生,股骨干骨折中有1例出现延迟愈合,尺桡骨骨折中有4例出现前臂旋后功能轻度受限。结论弹性髓内针能够满足患者和医生对手术微创、愈合迅速、住院时间短、恢复优良等要求,是目前最适合儿童四肢长管状骨骨折的内固定方法。
Objective To investigate the therapeutic effects of elastic stable intramedullary nail(ESIN) on long tubular fracture of four limbs in children.Methods The clinical data about 146 children patients with long tubular fracture of four limbs including the therapeutic effects, postoperative complications, fracture healing status and limbs functional rehabilitation status were analyze and summarized,who were treated by ESIN in our hospital in recent 5 years.Results All the patients were followed up for 6～12 months,with the average follow-up time being 8.7 months.A total of 145 patients had fracture primary healing, without postoperative complications including vascular injury,nerve injury and tendon injury,of whom, 1 patient with femoral shaft fracture had delayed healing,and 4 patients with ulnar radius fracture had forearm supination function limitation.Conclusion The elastic stable intramedullary nail can meet the needs of patients and doctors for minimally invasive surgery,rapid healing,short hospital stay and excellent recovery,which is the most suitable internal fixation method for children with long tubular bone fractures.
Objective To investigate the therapeutic effects of elastic stable intramedullary nail(ESIN) on long tubular fracture of four limbs in children.Methods The clinical data about 146 children patients with long tubular fracture of four limbs including the therapeutic effects, postoperative complications, fracture healing status and limbs functional rehabilitation status were analyze and summarized,who were treated by ESIN in our hospital in recent 5 years.Results All the patients were followed up for 6～12 months,with the average follow-up time being 8.7 months.A total of 145 patients had fracture primary healing, without postoperative complications including vascular injury,nerve injury and tendon injury,of whom, 1 patient with femoral shaft fracture had delayed healing,and 4 patients with ulnar radius fracture had forearm supination function limitation.Conclusion The elastic stable intramedullary nail can meet the needs of patients and doctors for minimally invasive surgery,rapid healing,short hospital stay and excellent recovery,which is the most suitable internal fixation method for children with long tubular bone fractures.
引文
1 周曙光,陈建闻,俞辉国.弹性髓内针治疗儿童长骨干骨折.实用骨科杂志,2012,18:306-307.
2 Grace TG,Eversmann WW.Foeram fractures.Treatment by rigid fixation with early motion.Bone Joint Surg,1980,62:433-438.
3 James HB,James RK.Fractures in children.Lippincott Williams &Wilkins,2005,30:317-322.
4 易先宏,潘骏,宋永焕,等.弹性髓内钉与动力加压接骨板治疗儿童不稳定尺桡骨骨折疗效比较.中医正骨,2009,21:23-25.
5 朱建,李立.弹性髓内钉在治疗小儿长骨骨折中的问题及并发症.中华创伤杂志,2014,30:440-442.
6 王伟,程少文,彭磊,等.弹性髓内钉在儿童肱骨干骨折中的应用.临床小儿外科杂志,2011,10:30-32.
7 郑江生.弹性髓内钉在儿童肱骨干骨折治疗中的应用.临床骨科杂志,2012,15:164-166.
8 de Sanctis N,Andreacchio A.Elastic sable intramedullary nailing is the best treatment of unicameral bone cysts of the long bones in children:Prospective long-term flollow-up study.J Pediatr Ortop,2006,31:520-525.
9 朱通伯,戴克戎主编.骨科手术学.北京:人民卫生出版社,1999.331.
10 Dietz JF,Bae DS,Eeiff E,et al.Single bone intramedullary fixation of the ulna in pediatric both bone forearm fractures:analysis of short-term clinical and radiographic results.Pediatr Orthop,2010,30:420-424.
11 Laseombes P,Haumont T,Journeau P.Use and abuse of flexible intramedullary nailing in children and adolescents.J Pediatr Orthop,2006,26:827-834.
12 唐立群.钛制弹性髓内针治疗儿童尺桡骨双骨折.创伤外科杂志,2008,10:464.
13 唐坚,孙月华,李慧武,等.钛弹力钉治疗儿童尺桡骨下1/3双骨折.中国矫形外科杂志,2006,8,14:582-584.
14 Schmittenbecer PP.Dietz HC.Indications for ESIN during skeletal growth.Akt Chir,1995,30:171-179.
2 Grace TG,Eversmann WW.Foeram fractures.Treatment by rigid fixation with early motion.Bone Joint Surg,1980,62:433-438.
3 James HB,James RK.Fractures in children.Lippincott Williams &Wilkins,2005,30:317-322.
4 易先宏,潘骏,宋永焕,等.弹性髓内钉与动力加压接骨板治疗儿童不稳定尺桡骨骨折疗效比较.中医正骨,2009,21:23-25.
5 朱建,李立.弹性髓内钉在治疗小儿长骨骨折中的问题及并发症.中华创伤杂志,2014,30:440-442.
6 王伟,程少文,彭磊,等.弹性髓内钉在儿童肱骨干骨折中的应用.临床小儿外科杂志,2011,10:30-32.
7 郑江生.弹性髓内钉在儿童肱骨干骨折治疗中的应用.临床骨科杂志,2012,15:164-166.
8 de Sanctis N,Andreacchio A.Elastic sable intramedullary nailing is the best treatment of unicameral bone cysts of the long bones in children:Prospective long-term flollow-up study.J Pediatr Ortop,2006,31:520-525.
9 朱通伯,戴克戎主编.骨科手术学.北京:人民卫生出版社,1999.331.
10 Dietz JF,Bae DS,Eeiff E,et al.Single bone intramedullary fixation of the ulna in pediatric both bone forearm fractures:analysis of short-term clinical and radiographic results.Pediatr Orthop,2010,30:420-424.
11 Laseombes P,Haumont T,Journeau P.Use and abuse of flexible intramedullary nailing in children and adolescents.J Pediatr Orthop,2006,26:827-834.
12 唐立群.钛制弹性髓内针治疗儿童尺桡骨双骨折.创伤外科杂志,2008,10:464.
13 唐坚,孙月华,李慧武,等.钛弹力钉治疗儿童尺桡骨下1/3双骨折.中国矫形外科杂志,2006,8,14:582-584.
14 Schmittenbecer PP.Dietz HC.Indications for ESIN during skeletal growth.Akt Chir,1995,30:171-179.