钢板桥接内固定治疗儿童复杂股骨干骨折

摘要]目的 分析钢板桥接内固定治疗儿童复杂股骨干骨折的临床疗效。方法 回顾性分析2010年7月至2015年3月中国人民解放军联勤保障部队第910医院收治的55例儿童股骨干骨折患儿资料，所有患儿均采用钢板桥接内固定。其中，男38例，女17例；年龄6.6 ～ 13.7（9.3±2.7）岁，体重12.9 ～ 71.5（35.4±12.1） kg；单纯股骨干骨折26例，累及股骨近端骨折18例，累及股骨远端骨折11例。记录手术时间，术中出血量，放射暴露时间，骨折愈合时间，术后髋、膝关节功能和并发症。结果 所有患儿随访28 ～ 50（36.5±6.4）个月，均获得骨性愈合和正常关节功能。其中儿童股骨干骨折稳定型与不稳定型、体重≥45 kg与＜45 kg、不同骨折部位之间，手术时间、术中出血量、放射暴露时间、骨折愈合时间比较，差异无统计学意义（P>0.05）。术后严重并发症2例，其中1例内固定失败，1例深部感染。结论 钢板桥接内固定治疗儿童股骨干骨折，可以提供骨折愈合的可靠固定，损伤小，并发症少，适用于体重大、不稳定的复杂儿童股骨干骨折或累及干骺端的骨折。

Submuscular bridge plating technique for complex pediatric femoral metaphyseal fractures

Abstract]Objective To analysis the clinical effect of submuscular bridge plating technique on complex pediatric femoral diaphyseal fractures. Methods We retrospectively reviewed 55 patients with pediatric femoral diaphyseal fractures treated with submuscular bridge plating technique from July 2010 to March 2015 in the 910th Hospital of Chinese PLA. There were 38 males and 17 females.The age was 6.6-13.7(9.3±2.7) years. The weight was 12.9-71.5(35.4±12.1) kg. There were 26 cases for metaphyseal femoral fracture, and 18 cases for proximal femoral fracture, and 11 cases for distal femoral fracture. Operative time, blood loss, fluoroscopy time, fracture healing time, function of hip and knee postoperatively, and complications were recorded were recorded. Results All patients were followed up for 28-50 (36.5±6.4) months, and all fractures healed well and returned to full activity. There was no difference in regard to operative time, blood loss, fluoroscopy time, fracture healing time between unstable and stable pediatric femoral shaft fracture, between children weighting more than 45 kg and those weighting less than 45 kg, and among femoral shaft fracture, proximal femoral fracture and distal femoral fracture. There were two patients had major complications leading to unplanned surgeries: One implant failure and one deep infection. Conclusion Submuscular bridge plating technique in treating complex pediatric femur fractures provides reliable fixation for fracture healing, with less injury and fewer complications. It is suitable for complex femoral shaft fractures or fractures involving metaphysis in children with large and unstable body.