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目的评估超声引导下应用弹性髓内钉闭合复位内固定儿童股骨干骨折的临床疗效。方法股骨干骨折患者20例作为治疗组,在超声引导下使用弹性髓内钉对股骨干闭合性骨折的患儿行闭合复位内固定术。通过超声的定位和引导,将选好的弹性髓内钉从骨折的近端向远端置入,行骨折的复位和固定,并在此期间动态监测和评估骨折移位和复位的情况。对照组20例在C型臂透视行骨折复位固定。结果两组患者的手术时间、出血量、平均住院日、愈合时间差异无显著性(P>0.05),但超声引导组与C型臂透视组透视次数差异有显著性(P<0.05),明显减少放射线损害。以术后X线片评估弹性髓内钉位置及骨折复位为标准,两组病例均符合儿童骨折复位标准;C型臂透视组术后神经损伤1例,下肢麻木,3个月后恢复。结论超声引导下应用弹性髓内钉对儿童股骨干骨折行闭合复位内固定手术的临床疗效可靠,手术过程中不仅可实时动态观察骨折的复位情况,而且还可避免放射线的暴露。
Objective To evaluate the clinical effects of ultrasound-guided elastic intramedullary nail closure and internal fixation of femoral shaft fractures in children. Methods Twenty patients with femoral shaft fractures were treated by closed reduction and internal fixation under the guidance of ultrasound with elastic intramedullary nail in children with closed femoral shaft fracture. Through the positioning and guidance of ultrasound, the selected elastic intramedullary nail is inserted from the proximal end to the distal end of the fracture, and the fracture is reset and fixed. During this period, the displacement and the reset of the fracture are dynamically monitored and evaluated. Control group, 20 cases of C-arm fluoroscopy fracture reduction and fixation. Results There was no significant difference in operation time, blood loss, average length of hospital stay, and healing time between the two groups (P> 0.05). However, there was a significant difference in the number of fluoroscopy between the ultrasound-guided group and the C-arm fluoroscopy group (P <0.05) Reduce radiation damage. Postoperative radiographs were used to assess the location of elastic intramedullary nails and fracture reduction as the standard. Both groups were in line with the children’s fracture reduction criteria. C-arm fluoroscopy group had 1 case of postoperative nerve injury, numbness of the lower limbs and recovery after 3 months. Conclusion The application of elastic intramedullary nails under the guidance of ultrasound in the treatment of children’s femoral shaft fracture with closed reduction and internal fixation operation is reliable. During the operation, not only the reduction of fracture can be dynamically observed in real time, but also radiation exposure can be avoided.