弹性髓内钉及股骨锁定加压钢板治疗大龄儿童股骨粗隆下骨折的临床疗效比较

发布时间：2018-02-09 03:51

本文关键词： 弹性髓内钉锁定加压钢板股骨粗隆下骨折大龄儿童　出处：《中国修复重建外科杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的比较弹性髓内钉(titanium elastic nail,TEN)及股骨锁定加压钢板治疗大龄儿童股骨粗隆下骨折的临床疗效。方法回顾性分析2015年4月—2016年9月收治的35例股骨粗隆下骨折大龄(年龄7~13岁)患儿临床资料,其中19例采用闭合复位TEN内固定治疗(A组),16例采用切开复位锁定加压钢板内固定治疗(B组)。两组患儿年龄、性别、侧别、致伤原因、骨折分型、受伤至手术时间等一般资料比较差异无统计学意义(P0.05),具有可比性。记录术中透视次数、手术时间、术中失血量、骨折愈合时间等。末次随访时,根据Sanders评分标准对髋关节功能进行评价,根据Flynn等提出的下肢骨折评价标准进行疗效评价。结果两组患者均获随访,随访时间6~24个月,平均11.46个月。A组患者手术时间、术中失血量、骨折愈合时间均显著少于B组,但术中透视次数多于B组,差异均有统计学意义(P0.05)。所有患儿骨折均愈合,无内固定失效、深部组织感染、神经损伤、股骨头坏死等其他严重并发症发生。末次随访时,根据Sanders评分标准评价患侧髋关节功能,A组优14例、良4例、中1例,优良率94.74%;B组优12例、良3例、中1例,优良率93.75%;两组比较差异无统计学意义(χ~2=0.400,P=0.980)。根据Flynn评价标准,A组优13例、良5例、可1例,优良率94.74%;B组优11例、良3例、可2例,优良率87.50%;两组比较差异无统计学意义(χ~2=0.748,P=0.688)。结论对于儿童股骨粗隆下骨折,采用TEN及锁定加压钢板均可获得满意疗效;与锁定加压钢板相比,TEN治疗儿童股骨粗隆下骨折具有微创、安全、骨折愈合迅速等优点。
[Abstract]:Objective to compare the clinical efficacy of elastic intramedullary nail titanium elastic nailtrochanteric tene (TEN) and locking compression plate in the treatment of subtrochanteric femoral fractures in older children. Methods 35 cases of subtrochanteric fractures of femur treated from April 2015 to September 2016 were retrospectively analyzed. Clinical data of children aged 7 to 13 years, Among them, 19 cases were treated with closed reduction and TEN internal fixation. 16 cases of group A were treated with open reduction and locking compression plate internal fixation. There was no significant difference between injury and operation time (P 0.05). The number of times of fluoroscopy, the time of operation, the amount of blood lost during operation, the time of fracture healing, and so on were recorded. The function of hip joint was evaluated according to Sanders scoring standard, and the curative effect was evaluated according to the evaluation standard of lower extremity fracture proposed by Flynn et al. Results the patients in both groups were followed up for 6 ~ 24 months with an average of 11.46 months. The amount of blood lost during operation and the healing time of fracture in group B were significantly less than those in group B. but the times of fluoroscopy in group B were more than those in group B. the difference was statistically significant (P 0.05). All the children had fracture healing, no failure of internal fixation, infection of deep tissues, and nerve injury. At the last follow-up, 14 cases were excellent, 4 cases were good, 1 case was fair, 12 cases were excellent, 3 cases were good, 1 case was middle, according to the Sanders score, the excellent and good rate was 94.74%. The excellent and good rate was 93.75. There was no significant difference between the two groups (蠂 ~ 2 / 0.400 / P ~ (0.980)). According to the Flynn evaluation criteria, there were 13 excellent cases, 5 good cases, 1 fair case in group A, 11 cases excellent in group B, 3 cases good in group B, and 2 cases fair in group B. The excellent and good rate was 87.50. There was no significant difference between the two groups (蠂 ~ 2 / 0.748P ~ 0.6880.Conclusion in the treatment of subtrochanteric fracture of femur in children, TEN and locking compression plate can obtain satisfactory curative effect, compared with locking compression plate, the treatment of subtrochanteric fracture of femur in children is minimally invasive. Safety, fracture healing and other advantages.
【作者单位】：西南医科大学附属医院骨与关节外科;
【分类号】：R726.8

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