弹性髓内钉在儿童四肢长骨骨折中的应用和疗效分析

发布时间：2019-01-05 05:19

【摘要】：目的：本课题通过观察弹性髓内钉在儿童四肢长骨骨折中的应用，对弹性髓内钉治疗四肢长骨骨折的手术适应症和疗效作出客观的评价，以期更好地指导临床，从而为以后的进一步深入研究打下基础。方法：按随机数字表法，将初次筛选合格病例共40例，分为2组，A组20例，应用弹性髓内钉对骨折进行固定，B组20例，应用钢板对骨折进行内固定。每组随诊时间为6-10月，两组患者均于术后定期进行X片复查，主要观察骨折对位对线情况、骨痂出现的时间、骨折愈合时间、临近关节功能及并发症的发生情况,从而分析结果及出现的原因。结果：所有患者随访时间6—10个月，两组患儿在随访期内全部愈合，对位对线良好，骨折愈合良好，无钉道感染，无不愈合或延迟愈合或骨髓炎病例，患儿负重、行走和活动功能完全恢复。结论：弹性髓内钉内固定适合于儿童四肢长骨骨干横形、短斜形和螺旋形骨折,在治疗小儿四肢长骨骨折方面优于钢板固定，能有效的缩短骨折愈合时间，能保护骨骺，，不损伤骨骺血管，使患者能更早的进行早期功能锻炼，髓内钉拔出方便，具有简便、微创、安全、术后康复快的优点。
[Abstract]:Objective: by observing the application of elastic intramedullary nail in the treatment of long bone fracture of extremities in children, objective evaluation was made on the indication and curative effect of elastic intramedullary nail in the treatment of long bone fracture of extremities, in order to better guide the clinical practice. Thus lay the foundation for further research. Methods: according to the method of random digital table, 40 cases were divided into two groups: group A (n = 20) treated with elastic intramedullary nail and group B (n = 20) treated with steel plate. The follow-up time of each group was 6 to 10 months. The patients in both groups underwent X ray reexamination regularly after operation. The fracture alignment, the time of callus appearance, the time of fracture healing, the function of adjacent joint and the occurrence of complications were observed. Thus, the results and the reasons for their appearance are analyzed. Results: all the patients were followed up for 6 to 10 months. All the children in the two groups were healed during the follow-up period, with good alignment, good fracture healing, no nail infection, no nonunion or delayed healing or osteomyelitis. Walking and activity functions are fully restored. Conclusion: elastic intramedullary nail internal fixation is suitable for the transverse, short oblique and spiral fractures of the long bone of extremities in children. It is superior to plate fixation in the treatment of long bone fractures of limbs in children. It can effectively shorten the time of fracture healing and protect the epiphysis. No injury to epiphyseal vessels, early functional exercise, intramedullary nail pull-out convenience, with simple, minimally invasive, safe, quick postoperative recovery advantages.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R726.8

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