共查询到20条相似文献,搜索用时 15 毫秒
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J N Ligier J P Metaizeau J Prévot P Lascombes 《The Journal of bone and joint surgery. British volume》1988,70(1):74-77
We report the use of elastic stable intramedullary nailing (ESIN) in 123 fractures of the femoral shaft in children. Flexible rods are introduced through the distal metaphyseal area, and the aim is to develop bridging callus. Early weight-bearing is possible and is recommended. There was one case of bone infection and no delayed union. Complications were minimal, the most common being minor skin ulceration caused by the ends of the rods. A surprising feature was the low incidence of growth changes, with a mean lengthening of only 1.2 mm after an average follow-up of 22 months. Compared with conservative treatment, ESIN obviates the need for prolonged bed rest and is thus particularly advantageous for treating children. 相似文献
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BACKGROUND: We present a retrospective analysis of a case series to evaluate closed intramedullary Kirschner wire (K-wire) fixation as a surgical technique in the treatment of femoral shaft fractures in children. METHODS: Fifty-three femoral shaft fractures (at various levels) were fixed by using closed intramedullary K-wires. The patient was placed supine on an orthopedic traction table. Under fluoroscopic control, two K-wires (2.5-3.5 mm thick) were introduced from distal metaphysis to the proximal metaphysis, one each, from medial and lateral cortices. In three distal fractures, K-wires were inserted antegrade from the proximal to distal metaphysis through the lateral cortex. Early mobilization and weight bearing was allowed. Mean hospital stay was 6.5 days, and K-wires were removed after a mean of 5.6 months. The study included seven open fractures as well. RESULTS: Sound unions were achieved between 6 and 10 weeks without any significant complication. CONCLUSION: Closed intramedullary K-wire fixation for femoral shaft fractures in children is a simple surgical technique that has excellent clinical and functional results. 相似文献
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2015年8月~2018年2月,我科采用弹性髓内钉内固定治疗20例儿童股骨骨折,临床效果良好,报道如下。1材料与方法1.1病例资料本组20例,男12例,女8例,年龄5~13岁。横行骨折14例,斜行骨折5例,螺旋形骨折1例。受伤至手术时间2~6 d。 相似文献
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Locked intramedullary nailing of femoral shaft fractures 总被引:2,自引:0,他引:2
One hundred twenty-three femoral shaft fractures were treated with Grosse-Kempf slotted, locked nails and followed for a median 20 (range, 12-60) months. There were eight intraoperative and 11 postoperative complications, among them two superficial and two deep infections. Most of the intraoperative complications and some postoperatively lost reductions could have been prevented by a better operative technique and judgment of stability. Seventy-eight results were graded as excellent, 24 as good, 19 as fair, and two as poor (one 9-cm shortening and one 40 degrees external malrotation). All fractures united without further procedures during the first year. 相似文献
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目的 探讨钛制弹性髓内钉(TEIN)治疗儿童股骨干骨折的疗效.方法 2004年11月至2006年12月共收治21例儿童股骨干骨折患者,在骨科牵引床上复位,C型臂机监控下顺行或逆行穿入TEIN 固定.术后酌情外固定3~4周,去除外固定后进行功能锻炼.结果 20例患者术后经平均8.2个月(6.5~19.0个月)随访,1例失访.骨折愈合时间平均为10.4周(8~12周).除4例单侧有针尾皮肤软组织刺激症外,未发现其他并发症.5例患者骨折成角5°~10°;3例下肢短缩,短缩不超过1cm.无一例发生旋转畸形.所有患者患侧膝关节活动度与健侧相仿.结论 适当使用TEIN治疗儿童股骨干骨折,具有损伤小、应力遮挡小、不影响骨骺、骨折愈合好、患肢功能恢复快、并发症少等优点.但应严格掌握TEIN直径的选择、预弯的部位和程度、钉尾的处理等要点. 相似文献
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Hidenori Matsubara Hidetoshi Yasutake Eizo Matsuda Kenji Uehara Mitsuyuki Niwada Yoshikazu Tanzawa 《Journal of orthopaedic science》2005,10(2):187-191
From 1996 to 2002 we used intramedullary Kirschner wires to treat 19 femoral shaft fractures in 19 children (11 boys, 8 girls). Their ages ranged from 2 to 13 years (mean 5.8 years). The mean follow-up time was 3 years (range 4 months to 4 years 9 months). The technique was intramedullary pinning using a 2.5- to 3.0-mm Kirschner wire introduced through the greater trochanter followed by spica casting. All cases achieved bone union within 3 months. The mean angular deformity was 1.7° (range 0°–5°), and one patient had an external rotational deformity. The mean overgrowth was 7.5mm, but no patient had residual problems during activities of daily living. Our method has the following advantages: no need of traction, leaving bed earlier, ease of nursing, fewer radiographic examinations, less angular deformity. It also has several disadvantages: the need for an operation under general anesthesia, the need for metal removal, and an operation scar. This method can be considered as one option for treating femoral shaft fractures in children. 相似文献
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股骨干骨折主要发生于年轻人,多由严重创伤所致。髓内钉固定治疗股骨干骨折具有创伤小、闭合复位不破坏骨外膜血运、促进骨痂生长、可早期负重等优点,被视为治疗股骨干骨折的金标准。该文就髓内钉治疗股骨干骨折的历史、现状及存在的问题,如扩髓与不扩髓、锁定与动力化调整、闭合复位与开放复位等作一综述。 相似文献
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2004年4月~2005年12月,我科对11例股骨干骨折患者经扩髓带锁髓内钉治疗,疗效满意。1材料与方法1.1病例资料本组11例,男9例,女2例,年龄20~55岁,交通伤5例,坠落伤4例,重物砸伤2例,均为闭合性新鲜骨折。粉碎性骨折5例,斜形骨折3例,横形骨折3例;位于股骨干上1/3段5例,中1/3段4例,下 相似文献
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To assess the role of stainless steel flexible intramedullary fixation in unstable pediatric femur fractures, we compared a group of 41 stable (transverse or oblique) fractures with a group of 40 unstable (spiral and/or comminuted) fractures treated with stainless steel (Ender) nails placed through a single lateral insertion. The fractures were followed up until clinical and radiographic union was evident with an average follow-up period of 13 months. All fractures were healed at an average of 1.4 months. No infections or refractures occurred. Although minor radiographic angular deformities and shortening were present in both groups, no patient had a clinically detectable angular deformity. Two patients with stable fracture patterns had 10 to 20 degrees of asymmetry in foot progression angles, and 1 patient with an unstable fracture pattern (Winquist grade IV comminution) had a 3-cm limb length difference at final follow-up. Stainless steel flexible intramedullary fixation is effective for unstable pediatric femur fractures if cortical abutment is present. 相似文献
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目的 观察钛合金弹性髓内针固定治疗儿童股骨干骨折的临床疗效.方法 对49例5~13岁儿童股骨干骨折采用经皮闭合复位钛合金弹性稳定髓内针固定治疗,随访4~24个月.结果 全部病例未出现手术并发症,术后6~8周达到骨性愈合,患肢与健侧等长46例,2例较健侧长0.6~1.0 cm,1例缩短0.7 cm,均无跛行.X线摄片检查... 相似文献
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带锁髓内钉治疗股骨干骨折的临床观察 总被引:1,自引:2,他引:1
2001年3月~2003年8月,笔者用带锁髓内钉治疗股骨干骨折52例,疗效满意. 1材料与方法 1.1病例资料本组52例,男48例,女4例,年龄17~72岁.致伤原因:交通伤45例,坠落伤7例.新鲜骨折49例,陈旧骨折骨不连3例,其中钢板固定失败2例,梅花针固定失败1例.骨折位于中段35例,位于下1/3段9例,上1/3段8例.粉碎性骨折及斜形骨折45例,横形骨折7例. 相似文献
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John Anastasopoulos Charalampos Konstantoulakis Christos Plakogiannis George Matsinos 《Injury》2010,41(6):578-481
This retrospective study aims to evaluate the efficacy of flexible intramedullary (IM) nails as a fixation device of paediatric femoral shaft fractures. A total of 36 children with 37 closed fractures were treated by this method. The patients ranged in age from 7.2 to 13.5 years and the mean follow-up was 25.5 months. All patients had open femoral growth plates at the time of surgery. All fractures united and none of the patients needed re-operation. Complications included pain/irritation at the insertion site,6 superficial wound breakdown1 and one case of delayed union. No major complications were recorded. After nail removal, all children had full range of hip and knee motion. At final follow-up, although radiographs revealed that 44% of the children had malalignment at the fracture site in one or both planes, none of the children presented with clinical malalignment of the fractured limb. Maximum angulation that was calculated on the coronal plane was 5° into varus and on the sagittal plane 7° of anterior angulation (apex posteriorly). Leg-length discrepancy was assessed clinically and radiographically when needed. A total of 50% of the children had a leg-length inequality but none of them complained of a functional problem. Flexible nailing of diaphyseal fractures of the femur is a reliable method with a small learning curve and allows early mobilisation. Most of our minor complications were technique related and could be avoided. 相似文献
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目的:探讨弹性髓内钉闭合复位内固定治疗儿童双侧股骨干骨折的疗效及并发症。方法:自2005年2月至2008年3月采用弹性髓内钉闭合复位治疗儿童双侧股骨干骨折7例,男5例,女2例,年龄3~13岁,平均8.3岁。车祸伤6例,高处坠落伤1例。合并伤:肺挫伤2例,颅脑损伤3例,膀胱损伤1例,跟骨骨折1例,无神经血管损伤及骨筋膜室综合征,均为闭合性骨折。2例患者术后采用石膏辅助外固定。结果:7例患者均获得随访,时间21~37个月,平均30.3个月,无一例发生切口感染,无继发骨折移位及内固定物失效或断裂。7例患者14侧骨折全部愈合,骨愈合时间7~12周,平均8.7周。无延迟愈合,骨不连,旋转畸形,髋、膝关节的功能障碍。1例患者出现双下肢不等长(长度差5 mm)。根据Flynn提出的评分标准,结果均为优。结论:采用弹性髓内钉治疗儿童股骨干骨折符合生物学固定原则,创伤小,并发症少,是治疗儿童高能量损伤股骨骨折的较好选择。 相似文献
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Primary intramedullary nailing of open femoral shaft fractures 总被引:2,自引:0,他引:2
The cases of 60 patients with 63 open femoral fractures treated by primary reamed intramedullary nailing were retrospectively reviewed. Twenty-two were classified as Type I open fractures, 26 as Type II and 15 as Type III open fractures by Gustilo's classification. All fractures were treated by wound debridement followed by immediate reamed intramedullary nailing. There were five early soft-tissue infections and three late deep infections. Of the late infections, only one was osteomyelitis (1.6%). There were three nonunions and seven malunions. All of the complications were dealt with effectively by standard methods. We concluded that primary reamed intramedullary nailing is an effective alternative for the treatment of Type I and II open femur fractures and for Type III open femur fractures associated with multiple trauma. 相似文献
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Collin May Yi-Meng Yen Adam Y. Nasreddine Daniel Hedequist Michael T. Hresko Benton E. Heyworth 《Journal of children's orthopaedics》2013,7(3):235-243
Purpose
This study aims to critically analyze the major and minor complications that may be associated with plate fixation of pediatric diaphyseal femur fractures.Methods
The medical records of skeletally immature patients (6–15 years of age) who underwent plate fixation of a diaphyseal femur fracture at a tertiary-care level-1 pediatric trauma center between 1/2003 and 12/2010 were reviewed. Demographic and clinical information regarding the mechanism of injury, fracture type, and surgical technique were recorded. Radiographic evaluation of bony healing, hardware position, and deformity was performed throughout the study period. All intraoperative and postoperative complications were recorded. Complication incidence and time from surgery to complication were described. Multivariate logistic regression and multivariate Cox regression models were used to assess the association between different variables and the occurrence of a complication. Kaplan–Meier survivorship curves were used to evaluate the freedom from a complication with longer follow-up.Results
Over an 8-year period, 85 skeletally immature patients (83 % males, mean age 10.2 years) underwent plate fixation for diaphyseal femur fractures. Overall, complications were identified in 11 patients (13 %). Major complications, defined as those resulting in unplanned reoperation (excluding elective removal of asymptomatic plate/screws), occurred in five patients (6 %) and included two patients (2 %) with wound infections requiring irrigation and debridement, two patients (2 %) with distal femoral valgus deformity (DFVD) leading to osteotomy and hardware removal, respectively, and one patient (1 %) with a 3-cm leg length discrepancy (LLD) requiring epiphysiodesis. Minor complications, defined as those not requiring unplanned operative intervention, occurred in six patients (7 %) and included two patients (2 %) with delayed union, two patients (2 %) with symptomatic screw prominence, one patient (1 %) with a superficial wound infection effectively treated with oral antibiotics, and one patient (1 %) with valgus malunion, which was asymptomatic at early follow-up. There were no intraoperative complications and no reports of postoperative knee stiffness, shortening, or reoperations to address fracture stability. Fifty-two patients (61 %) underwent routine elective removal of hardware without related complications following fracture union. Overall, complications occurred postoperatively at a mean time of 20 months (range 0–65 months), though major complications occurred at a later time point (mean 29.1 months, range 0–65 months) than minor complications (mean 12.5 months, range 0–40.1 months). Longer follow-up was associated with higher occurrence of a complication [p = 0.0012, odds ratio = 1.05, 95 % confidence interval (CI): 1.02–1.08].Conclusions
The plating of pediatric femur fractures is associated with 6 and 7 % rates of major and minor complications, respectively. There were minimal long-term sequelae associated with the complications noted. This complication rate compares favorably with the published rate of complications (10–62 %) associated with titanium elastic nail fixation of similar fracture types. Most complications occurred >4 months postoperatively, with major complications occurring at a later time point than minor complications. Long-term follow-up of these patients is recommended to ensure that complications do not go undetected.Level of evidence
Retrospective case series, Level IV. 相似文献19.
W Niemyjski K Zo?yński K Kafar C Malicki 《Chirurgia narzadów ruchu i ortopedia polska》1989,54(3):233-236
Early and late complications of the treatment of 141 cases of femoral shaft fracture by various methods have been presented. The most frequent early complications were various forms of traumatic shock (ca. 28 per cent). Disturbances in bone union and infections were main late complications of femoral shaft fracture. Lack of bone union occurred in 7.8 per cent of the cases. Posttraumatic ostitis occurred in 4.9 per cent of the cases. 相似文献
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Background: The results of intramedullary nailing of femoral shaft fractures from Australian institutions have not been widely reported. This study examines a consecutive group of patients treated at a major metropolitan trauma centre and reports on the injury statistics and outcome data, and compares this to previously reported results from the literature. Methods: A total of 101 fractures in 97 consecutive adult patients were included in the study. Nine patients were excluded. At a minimum of 6 months post injury, 54 patients were interviewed by telephone and 35 patients presented for clinical review and underwent physical examination, computed tomography (CT) scanogram of the lower limbs and Short Form 36 questionnaires. Results: Road trauma accounted for 81% of injuries and 15% of fractures were open. Of the 54 patients reviewed, 13 (23%) required further surgery for delayed or non‐union. Of the 35 who presented for physical examination, there was poor correlation between perceived leg length discrepancy and measured leg length discrepancy on examination or scanogram. Presence of a limp correlated with measured leg length discrepancy of more than 1 cm but did not correlate with rotational abnormality measured on CT scanogram. Pain at the hip, thigh or knee was present in 60% of patients. The Short Form 36 scores for physical functioning, role ? physical, bodily pain, general health and vitality were all significantly lower than population norms with P values ranging from <0.001?0.05. Subgroup analysis comparing isolated femur fracture to multi‐trauma patients for all five of these parameters revealed significant differences only in the multi‐trauma group. Conclusion: The incidence of pain, limp, leg length discrepancy and delayed or non‐union is higher in this study than in previously reported results of intramedullary nailing for femoral shaft fractures. This may be due to differences in the patient population, the skill level of the operating surgeon, or incomplete follow up. 相似文献