弹性髓内钉与动力加压接骨板治疗儿童不稳定尺桡骨骨折疗效比较

目的：对采用弹性髓内钉及动力加压板治疗儿童不稳定尺桡骨折的操作情况、损伤情况、术后骨折愈合时间、住院费用、并发症及功能恢复等情况进行比较。方法：对我院骨科2004年1月至2007年12月间120例儿童尺桡骨骨折进行回顾性分析。采用闭合复位、弹性髓内钉固定（TEN组）32例，切开复位、动力加压接骨钢板内固定（DCP组）28例。分别对两组患者的一般资料，手术情况及术后并发症、功能恢复情况进行评估比较。结果平均手术时间TEN组38．4min，DCP组74．2min；术中出血量TEN组10mL，DCP组73．7mL；平均切口长度TEN组6．4cm，DCP组11．8cm。组间比较差异有统计学意义。所有病例均获随访，TEN组随访时间12—32个月（平均26．3个月），DCP组随访时间13～34个月（平均27．8个月）。TEN组平均愈合时间为6．7周，DCP组为10．4周；TEN组并发症发生率为6％，DCP组为14．3％；已取出内固定的病例总的医疗费用比较，TEN组平均10290．9元，DCP组为12057．1元；组间比较差异有统计学意义。按照Anderson评分标准，弹性髓内钉组优良率平均为93．2％，DCP组为92．7％，两组比较差异无统计学意义。结论：应用弹性髓内钉与DCP治疗儿童不稳定尺桡骨骨折在术后功能方面无差异，但TEN较DCP损伤小，术后恢复快，并发症较少；住院时间短、总体费用低有利于减轻患方经济负担。

Comparison of titanium elastic nails with Dynmic Compression Plates to treat Unstable Radial and Ulnar Shaft Fractures In Chil-dren

ObJective：To compare the informations of manipulation, traumatic condition, healing times post-operation, cost of hospitalization, complication and functional recovery on titanium elastic nails （TEN） with dynmic compression plates （DCP） to cure pediatric unstable radial and ulnar fractures. Methods： 60 cases of children with consecutive unstable radial and ulnar fractures for hospitalization and treatment were made for retrospective analysis. They were divided into TEN group （32 cases, closed replacement and TEN fixed） and DCP group （28 cases, open reduction and DCP used for internal fixation）. Such items as clinical and operative data, postoperative complications and functional recovery dat were evaluated and analyzed. Results ： During the course of operation, the mean operation time of two groups were respectively 38.4 min and 74. 2 min, the bleeding volume were respectively 10 ml and 73.7 ml. The mean length of incision were respectively 6.4cm and 11.8cm. There was significant difference between two groups （P 〈 0.01 ）. All patients were made for followup, the time of TEN group was from 12 months to 32 months, average 26. 3 months ,that of DCP group was from 13 months to 34 months, average 27.8 months. All fractures healed , the average times of two groups were respectively 6. 7 weeks and 10.4 weeks. The rate of complications was 6% in TEN group and 14. 3% in DCP group. The total expense of hospitalization after metal work removed was averagely ￥ 10290. 9 in TEN group and ￥ 12057.1 in DCP group. There had significant difference between the two groups. According to assessment criterion of Anderson？ s： the total excellent and good rates of two groups were respectively 93.2% and 92. 7%, there had no statistical significance on difference of two groups （P 〈 0. 01 ）. Conclusion： For TEN and DCP used to cure pediatric unstable radial and ulnar fractures, there had no difference on post-operation function of them. Compared with DCP, TEN had such merits as tiny damage, quick