儿童长骨骨折弹性髓内针治疗后骨延迟愈合及不愈合

目的 分析弹性髓内针( ESIN)技术治疗儿童长骨骨折术后出现骨延迟愈合及骨不愈合的病例,探讨其出现的可能原因.方法 分析回顾2005年至2010年我院ESIN治疗儿童长骨骨折术后出现骨延迟愈合及不愈合的患儿12例,患儿年龄2岁7个月～12岁3个月,其中股骨2例,胫腓骨2例,尺桡骨6例,肱骨2例,手术均在外伤后1d内完成.结果 5例出现延迟愈合,7例不愈合.7例单纯取出内固定愈合,4例通过取出髓内针,断端植骨,换用其他固定方式愈合,1例失随访.结论 弹性髓内针治疗儿童长骨干骨折固然是一种很好的方法,但是进行该手术时需严格遵循手术操作规范,把握适应证,同时该针在固定断端的抗旋转,加压,以及髓内应力分布不均等方面也有其弱势,需要根据具体病例情况,有选择地应用.

Delayed union and nonunion of long bone shaft fractures in children after elastic stable intramedullary nailing

Objective To analyze the causes of delayed union or nonunion of long bone shaft fractures in children after elastic stable intramedullary nailing(ESIN).Methods We studied a series of children treated by ESIN for long bone shaft fractures from 2005 to 2010.Twelve cases did not get bony consolidation after 4 months of ESIN,including 2 femur fracture,2 tibia and fibula fracture,6forearm fracture and 2 humeral fracture,the patients age ranged from 2.58 years to 12.25 years.Results Seven patients healed after the removal of the nail,4 patients healed after removed the nail with bone graft and changed to another fixation.Conclusions Using the elastic stable intramedullary nailing to treat the long bone shaft fractures of limbs in children is no doubt a good method.However,since it also has some defects in the control of rotation,it is recommended to use it more individually.