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目的探讨儿童股骨干骨折的微创弹性髓内针复位固定及切开复位LC-DCP钢板内固定两种治疗术式的优劣性。方法 2007年4月—2010年5月期间昌黎县人民医院收治的6～13岁39例儿童股骨干骨折病例,其中微创通过弹性髓内针复位固定18例,切开复位LC-DCP钢板内固定21例。所选取的病例均为股骨干骨折,所有病例均未植骨。术后X线复查。37例均得到随访,随访时间为5～15个月,平均10个月,并应用HSS评分系统(主观评分系统)进行结果分析评价。结果 21例钢板手术后18周内骨折骨性愈合,骨折延迟愈合1例,过度生长1例;术后伤口全部一期愈合,无手术并发症出现;18例弹性髓内针,术后14周内骨性愈合,2例过度生长。结论对于儿童股骨干骨折采用微创弹性髓内针复位固定是一种微创内固定,效果可靠的治疗方法。效果与切开复位钢板内固定一样理想。但价格昂贵,并需要C型臂,不适于基层医院开展。术者可以根据具体情况选择合适患者的手术方法。
Objective To investigate the advantages and disadvantages of two minimally invasive elastic intramedullary nail fixation and open reduction and internal fixation with open reduction LC-DCP in children with femoral shaft fractures. Methods From April 2007 to May 2010, 39 cases of 6-year-old children with femoral shaft fracture in Changli County People’s Hospital were treated by minimally invasive fixation of 18 cases with elastic intramedullary nailing. All patients underwent LC-DCP Fixed 21 cases. Selected cases were femoral shaft fractures, all cases were not bone graft. Postoperative X-ray review. All the 37 cases were followed up for 5-15 months with an average of 10 months. The results were analyzed by HSS score system (subjective scoring system). RESULTS: Twenty-two weeks after operation, bone fracture healing occurred in 18 cases, delayed fracture healing in 1 case and over-growth in 1 case. All the wounds were healed one time without complications. Eighteen elastic intramedullary nails Endosteal healing, 2 cases of overgrowth. Conclusion The use of minimally invasive elastic intramedullary nailing in the fixation of femoral shaft fractures in children is a minimally invasive and effective internal fixation method. Effect and open reduction plate as ideal. But expensive, and require C-arm, not suitable for primary hospital. The surgeon can choose the appropriate patient’s surgical method according to the specific circumstances.