弹性髓内针治疗儿童长骨骨折

目的探讨弹性髓内针固定治疗儿童长骨骨折的并发症及预后。方法回顾性总结我院2004年1月至2010年5月收治的47例儿童非粉碎性长骨骨折,包括肱骨骨折、尺骨桡骨骨折、股骨骨折、胫骨骨折。47例患儿中,男性27例,女性20例;年龄6~14岁。肱骨骨折6例,尺桡骨骨折20例,股骨骨折15例,胫骨骨折6例。对于尺桡骨骨折,采用麻醉下闭合复位,单根弹性髓内针固定,石膏固定2~3周后自主活动。对于肱骨、股骨、胫骨骨折,采用麻醉下闭合复位,双根弹性髓内针交叉固定。肱骨骨折后石膏固定3周后自主活动;股骨、胫骨骨折石膏固定5~6周,8~10周后完全负重行走。结果 47例患儿经弹性髓内针内固定治疗后,骨痂生长良好,均获治愈,并且关节功能恢复正常,无严重的并发症。结论术前合理选择患儿年龄、骨折类型,采用弹性髓内针治疗儿童长骨骨折,具有微创、安全、简便、复位好、恢复快和并发症少的优势。

Treatment of Long Bone Fracture in Children with Flexible Intramedullary Nail

Objective To explore the results of using flexible intramedullary nails in the treatment of children′s long bone fractures.Methods From 2004 to 2010,47 children(47male,20 female) with non-crash long bone fractures were analysed retrospectively.Fracture of humerus,fracture of radius and ulna,fracture of femur,fracture of tibia were included.The patients were 6~14 years old.There are fracture of humerus in 6 patients,fracture of radius and ulna in 20 patients,fracture of femur in 15 patients,fracture of tibia in 6 patients,the fracture of radius and ulna affected children were treated by closed reduction,fixing of single flexible intramedullary nail.After 2~3 weeks of fixation,autonomic activities are allowed.Fracture of humerus、femur and tibia were reducted,fixed with two flexible intramedullary nails.After 3 weeks of fixation,autonomic activities of pectoral limb are allowed.In humeral fracture patients children with femur or tibia fracture were fixed for 5~6 weeks.The patients were allowed to walk after 8~10 weeks.Results All the fractures were cured.Full range of motion in the nearby joints was reserved.No severe complications were found.Conclusion For suitable patients,the therapy using flexible intramedullary nails is a safe,easy and minimal invasive technique.The affected children recovered quickly with fewer complications.