可吸收钉/棒治疗儿童四肢骨干及干骺端骨折

目的 探讨采用可吸收钉/棒治疗儿童四肢骨干和干骺端骨折的适应证和技巧.方法 采用超高分子聚-DL-乳酸(PDLLA)制成的可吸收钉/棒治疗部分儿童四肢骨干和干骺端骨折56例.小切口切开复位后1至3枚钉棒内固定,术中检查稳定性是否良好;术后肢体行石膏或支具外固定3～8周,2～3周后间断拆石膏进行关节功能训练,3～4周定期复查X线片,观察骨痂生长情况.结果 随访44例,患儿术后平均随访5.5个月(3～12个月).全部骨折无移位,均愈合良好,伤口无红肿渗出,无细菌感染.结论 小切口PDLLA可吸收钉棒治疗儿童四肢骨干和干骺端骨折,操作简单,创伤小,效果理想,避免再次手术,是治疗小儿四肢长管状骨骨折比较理想的方法之一,可以选择使用.

Fixation with absorbable PDLLA screws or sticks on diaphyseal and metaphyseal fractures of extremities in children

Objective To discuss the indications and techniques of fixation with absorbable PDLLA screws or sticks on diaphyseal and metaphyseal fractures of extremities in children. Methods Between June 2002 and May 2007, 44 children (male 30, female 14) with diaphyseal and metaphyseal fractures of extremities were treated. Their ages ranged from 1-10 year with mean of 5.5 years. The lesion of fractures included femurs in 10 cases; tibiofibulas in 6; humeri in 16 and ulnoradii in 12. The surgical procedures were open reduction and internal fixation with one to three absorbable PDLLA screws or sticks through minimal incision, and plaster cast or plaster support fixation for 3-8 week. The joint functional training was started 2-3 week postoperatively. In order to check the process of bony union of fracture, X-ray examination was taken at regular intervals of 3 to 4 weeks. Results Forty-four patients were followed up for 3 to 12 months (mean 5. 5 months). The bony union was achieved without displacement, swelling or infection. Conclusions Minimally invasive treatment of diaphyseal and metaphyseal fractures with fixation of absorbable PDLIA screw or stick is a simple and effective method for treating fractures of extremities in children. It can avoid re-do operation.