弹性髓内钉与钢板内固定治疗小儿股骨干骨折的疗效比较

王占东，边鹏辉

（1.富平县朱老二骨伤医院，陕西 渭南，711700；2.铜川市王益区骨伤医院，陕西 铜川，727000）

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摘要：

目的 比较钛合金弹性髓内钉（TEN）与钢板内固定治疗小儿股骨干骨折的临床疗效。方法 回顾性分析我院收治的小儿 股骨干骨折68例，其中，采用TEN内固定44例，采用钢板内固定24例。观察并比较两组患儿的手术相关情况，根据Flynn提出的小儿股骨干骨折的评分标准评估患儿治疗效果。结果 随访12~18月，平均随访16月，术后患儿伤口均愈合。患儿骨折均于术后6月内达到骨性愈合。均无畸形愈合、延迟愈合、骨不连和感染，也无内固定物断裂。钢板内固定组手术时间、术中出血量、骨折愈合时间大于TEN内固定组（P<0.05）。两组患儿完全负重时间比较差异无统计学意义（P>0.05）。TEN内固定组5例出现针尾激惹症状，骨折愈合后取出髓内钉后症状消失。按Flynn评分标准评定：TEN内固定组中，优40例，良4例；钢板内固定组中，优21例，良4例。两组优良率比较差异无统计学意义（P>0.05）。结论 TEN治疗小儿股骨干骨折具有创伤 小、出血少、骨折愈合快及并发症少等优点，但钢板内固定对粉碎性骨折有其优势。

关键词：髓内钉；钢板；股骨干骨折；内固定

中图分类号：R726.8文献标志码：A文章编号：2096-1413(2017)08-0006-03

Clinical effect comparison of elastic stable intramedullary nailing and plate internal fixation on children

with femoral shaft fractures
WANG Zhan-dong 1, BIAN Peng-hui 2
(1. Fuping Zhulao'er Fractures Hospital, Weinan 711700; 2. Wangyi District Fractures Hospital

of Tongchuan,Tongchuan 727000, China)

ABSTRACT: Objective To compare the clinical effect of elastic stable intramedullary nailing and plate internal fixation on children with femoral shaft fractures. Methods The clinical data of 68 children with femoral shaft fractures admitted in our hospital were retrospectively analyzed. There were 44 children received elastic stable intramedullary nailing fixation, and 24 children accepted plate internal fixation. The operation conditions of two groups were observed and compared, and the clinical effect of the children were assessed with infantile femoral fracture criteria according to Flynn. Results All the children were followed up for 12 to 18 months, with an average follow-up for 16 months, and the postoperative wound all heal. Bony healing fractures were recorded in 6 month with no malunion, delayed union, nonunion and bone infections; at the same time, there was no fracture internal fixation. The operation time, intraoperative blood loss and fracture healing time of the elastic stable intramedullary nailing fixation group were longer than those of the plate internal fixation group (P<0.05); there was no significant difference on full weight -bearing time between two groups (P>0.05). There were 5 children occurred needle tail irritability in the elastic stable intramedullary nailing fixation group, the symptoms disappeared when the fracture healing after removing intramedullary nail. According to Flynn grading standard, 40 cases were excellent, 4 cases were good in elastic stable intramedullary nailing fixation group; and 21 cases excellent, 3 cases were good in plate internal fixation group; there was no significant difference on the excellent rate of two groups. Conclusion Elastic stable intramedullary nailing fixation on children with femoral shaft fractures has small trauma, less bleeding, quicker fracture healing and fewer complications. But steel plate internal fixation for comminuted fracture has its advantages.
KEYWORDS: intramedullary nail; steel plate; femoral shaft fractures; internal fixation

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