应用Ilizarov外固定技术治疗儿童股骨下段螺旋形骨折
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摘要
目的探讨应用Ilizarov外固定技术治疗儿童股骨下段螺旋形骨折的临床疗效。方法 2011年8月～2015年10月应用Ilizarov环形外固定技术治疗儿童股骨下段螺旋形骨折患者11例。其中男7例,女4例;年龄:6岁～12岁,平均8岁。按照Ilizarov穿针原则固定外固定架后通过调整螺纹杆的螺母,利用间接复位技术达到骨折断端的复位。Ilizarov外固定技术操作简单、固定可靠,便于患者早期下床活动,关节功能锻炼。结果 11例患者骨折临床愈合时间:2.5个月～4.5个月,平均3.5个月。拆除外固定时间:3个月～6个月,平均4个月。其中2例患者出现钉道炎症反应,对症处理后感染消失。术后随访时间12个月～24个月,平均18个月,膝关节功能情况按照Kolmert等评定标准:优9例,良1例,可1例,差0例,优良率91%。结论应用Ilizarov外固定技术是治疗儿童股骨下段螺旋形骨折的有效手段。
Objective To investigate the clinical efficacy of Ilizarov external fixation in the treatment of spiral fractures of the lower femur in children.Methods August 2011 to 2015 October Ilizarov circular external fixation treatment of children femoral inferior segment spiral shaped fractures were 11 cases.The male 7 cases, males and 4 females;age:aged 6 to 12,with an average of 8 years.In accordance with the Ilizarov fixation principle fixed external fixator through adjusting screw rod nut,using indirect reduction techniques to the fracture end reset using Ilizarov external fixation technique has the advantages of simple operation, reliable fixation, easy to early ambulation of patients with joint function exercise.Results 11 cases of patients with clinical healing time of fracture:2.5 months to 4.5 months,with an average of 3.5 months.Remove external fixation time:3 months to 6 months average 4 months.The 2 patients appear nail tract inflammation,symptomatic treatment after infection disappears.Postoperative followup time of 12 months to 24 months,with an average of 18 months,the knee joint function according to kolmert assessment standard:excellent in 9 cases,good in 1 case, 1 case,poor in 0 cases,the excellent and good rate was 91%.Conclusion Application is fixed outside the Ilizarov technique under the treatment of children femoral spiral fracture of the effective means.
Objective To investigate the clinical efficacy of Ilizarov external fixation in the treatment of spiral fractures of the lower femur in children.Methods August 2011 to 2015 October Ilizarov circular external fixation treatment of children femoral inferior segment spiral shaped fractures were 11 cases.The male 7 cases, males and 4 females;age:aged 6 to 12,with an average of 8 years.In accordance with the Ilizarov fixation principle fixed external fixator through adjusting screw rod nut,using indirect reduction techniques to the fracture end reset using Ilizarov external fixation technique has the advantages of simple operation, reliable fixation, easy to early ambulation of patients with joint function exercise.Results 11 cases of patients with clinical healing time of fracture:2.5 months to 4.5 months,with an average of 3.5 months.Remove external fixation time:3 months to 6 months average 4 months.The 2 patients appear nail tract inflammation,symptomatic treatment after infection disappears.Postoperative followup time of 12 months to 24 months,with an average of 18 months,the knee joint function according to kolmert assessment standard:excellent in 9 cases,good in 1 case, 1 case,poor in 0 cases,the excellent and good rate was 91%.Conclusion Application is fixed outside the Ilizarov technique under the treatment of children femoral spiral fracture of the effective means.
引文
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[11]Semaan A,Klein T,Boemers TM,et al.Therapy of pediatric femoral fractures.Two versus three Elastic stable intramedullary nails.Unfal lchirurg,2015,118(1):42-47.
[12]李刚,孙伟.小儿股骨干骨折应用外固定支架的治疗体会[J].基础医学论坛.2013,17(1):128-129.
[13]宋连新,彭阿钦齐向北,等.外固定支架治疗儿童股骨干骨折30例.[J].中国骨与关节损伤杂志.2006,21(4):309-310.
[14]罗雷茗,鲁晓波,伍伟,等.闭合与切开复位弹性髓内钉内固定治疗儿童股骨粗隆下骨折疗效比较[J].中国修复重建外科杂志.2015.29(11):1337-1341.
[15]Ilizarov G A Transosseous osteosynthesis[M].NewYork,Springer Verlag 1992.
[16]董长红,蒋守海,徐明亮,等.Ilizarov技术结合跗骨V形截骨治疗创伤性马蹄内翻足[J].中国修复重建外科杂志,2015,29(12):1474-1477.
[17]夏和桃.外固定器刚度对骨折愈合的影响[J].中华创伤骨科杂志.2007.12;1170-1172.
[18]王岩.坎贝尔骨科手术学[M].12版.北京:人民军医出版社,2013:1353.
[19]戴尅戎,荣国威.骨折治疗的A O原则[M].北京:华夏出版社,2003:249.
[20]周宏艳,左玉明,赵红波,等.弹性髓内钉治疗儿童股骨粗隆下骨折的疗效分析[J].中国骨与关节损伤杂志,2012,27(6):535-536.
[2]吴克俭,候树勋.骨科实用固定技术[M].北京:人民军医出版社,2007:1137-1140
[3]Kolmert L,Wulff K.Epidemiology and treatment of distal femoral fractures in adults[J].Acta Orthop Seand,1982,53(6):957-962.
[4]James H.Beaty James R,Kasser著:黄耀添等译.洛克伍德-威尔金斯儿童骨折.第7版.北京:人民军医出版社,2014.3,753,768.
[5]吴泉州,张菁,兰树华.弹性髓内钉固定与外固定支架治疗儿童股骨干骨折疗效比较[J].中国骨伤,2011,24(2):146-148.
[6]Flynn JM,Luedtke LM,Ganley TJ,et al.Comparison of titanium elastic nails with traction and a spica cast to treat femoral fractures in children[J].J Bone Joint Surg Am,2004,86(4):770-777.
[7]Metaizeau JP.Stable elastic intramedullary nailing for fractures of the femur in children.J Bone Joint Surg(Br),2004,86(7):954-957.
[8]谭家昌,杨有猛等.AO弹性髓内钉微创治疗儿童股骨干骨折疗效观察.[J]中国骨与关节损伤杂志2011,26(10):919-920.
[9]Salonen A,Lahdes-Vasama T,Mattila VM,et al.Pitfalls of femoral titanium elastic nailing.Scand J Surg,2015,104(2):121-126.
[10]Nisar A,Bhosale A,Madan SS,et al.Complications of Elastic Stable intramedullary Nailing for treating paediatric long bone fractures.JOrthop,2013,10(1):17-24.
[11]Semaan A,Klein T,Boemers TM,et al.Therapy of pediatric femoral fractures.Two versus three Elastic stable intramedullary nails.Unfal lchirurg,2015,118(1):42-47.
[12]李刚,孙伟.小儿股骨干骨折应用外固定支架的治疗体会[J].基础医学论坛.2013,17(1):128-129.
[13]宋连新,彭阿钦齐向北,等.外固定支架治疗儿童股骨干骨折30例.[J].中国骨与关节损伤杂志.2006,21(4):309-310.
[14]罗雷茗,鲁晓波,伍伟,等.闭合与切开复位弹性髓内钉内固定治疗儿童股骨粗隆下骨折疗效比较[J].中国修复重建外科杂志.2015.29(11):1337-1341.
[15]Ilizarov G A Transosseous osteosynthesis[M].NewYork,Springer Verlag 1992.
[16]董长红,蒋守海,徐明亮,等.Ilizarov技术结合跗骨V形截骨治疗创伤性马蹄内翻足[J].中国修复重建外科杂志,2015,29(12):1474-1477.
[17]夏和桃.外固定器刚度对骨折愈合的影响[J].中华创伤骨科杂志.2007.12;1170-1172.
[18]王岩.坎贝尔骨科手术学[M].12版.北京:人民军医出版社,2013:1353.
[19]戴尅戎,荣国威.骨折治疗的A O原则[M].北京:华夏出版社,2003:249.
[20]周宏艳,左玉明,赵红波,等.弹性髓内钉治疗儿童股骨粗隆下骨折的疗效分析[J].中国骨与关节损伤杂志,2012,27(6):535-536.