摘要
目的探讨弹性髓内钉治疗儿童胫骨骨折的疗效。方法将63例胫骨骨折患儿根据手术方式不同分为弹性髓内钉组(采用弹性髓内钉治疗,40例)和外固定架组(采用外固定架治疗,23例)。记录手术时间、术中出血量、住院时间、骨折愈合情况、关节活动度及并发症发生情况,采用Johner-Wruhs评分标准评价疗效。结果患儿均获得随访,时间6~12个月。手术时间、术中出血量、住院时间、骨折愈合时间弹性髓内钉组均短(少)于外固定架组(P<0.01)。下地负重时间、固定物去除时间弹性髓内钉组均长于外固定架组(P<0.01)。末次随访时,膝关节活动度及踝关节活动度弹性髓内钉组均优于外固定架组(P<0.01、P<0.05);两组疗效优良率比较差异无统计学意义(P>0.05)。术后并发症发生率两组比较差异无统计学意义(P>0.05)。结论弹性髓内钉治疗儿童胫骨骨折创伤小,骨折愈合时间短,但下地负重及去除固定物时间较晚。
Objective To investigate the effect of elastic intramedullary nail foRtreatment of tibial fractures in children.Methods A total of 63 children with tibial fractures were divided into elastic intramedullary nail group(40 cases were treated with elastic intramedullary nail)and external fixatoRgroup(23 cases were treated with external fixator),according to different surgical methods.The operation time,intraoperative blood loss,hospitalization time,fracture healing conditions,joint range of motion and complications were recorded,and the Johner-Wruhs score was used to evaluate the curative effect.Results All patients were followed up foR6~12 months.The operation time,intraoperative blood loss,hospital stay,and fracture healing time were shorteR(less)in the elastic intramedullary nail group than those in the external fixatoRgroup(P<0.01).The weight-bearing time and fixation removal time in the elastic intramedullary nail group were longeRthan those in the external fixatoRgroup(P<0.01).At the last follow-up,the range of motion of the knee joint and the range of motion of the ankle joint were both betteRin the elastic intramedullary nail group than those in the external fixatoRgroup(P<0.01,P<0.05);the excellent-good rate of the two groups had no difference(P>0.05).The incidence rate of complications of two groups had no statistical difference(P>0.05).Conclusions Elastic intramedullary nailing in the treatment of children′s tibial fractures has less trauma,shorteRfracture healing time,but the weight-bearing time and the fixation removal time are relatively later.
作者
孙伟
刘巍
李家福
龙大伟
SUN Wei;LIU Wei;LI Jia-fu;LONG Da-wei(SectionⅤ,Dept of Orthopaedics,Taihe TCM Hospital Affiliated to Anhui University of Chinese Medicine,the TCM Hospital of Taihe County,Fuyang,Anhui 236600,China)
出处
《临床骨科杂志》
2022年第4期571-575,共5页
Journal of Clinical Orthopaedics
关键词
弹性髓内钉
儿童胫骨骨折
elastic intramedullary nail
tibial fracture in children
作者简介
孙伟,男,主治医师,主要从事四肢创伤研究,E-mail:sunwei19812@163.com。
