钛合金弹性髓内钉治疗儿童四肢长骨干骨折的效果观察

目的探讨钛合金弹性髓内钉（TEN）治疗儿童四肢长骨干骨折的疗效。方法 2008年12月-2011年9月共收治45例儿童四肢长骨干骨折患者,分别给予切开复位钢板固定（钢板固定组）和钛合金弹性髓内钉固定（弹性髓内钉组）方法治疗。所有病例均记录手术时间、失血量、骨折X线愈合时间、住院时间及负重时间情况。结果 45例患者术后经平均10.5个月随访,钢板固定组平均骨折愈合时间为14.5周,弹性髓内钉组平均骨折愈合时间为9.8周,两组比较差异有统计学意义（P〈0.05）。弹性髓内钉组手术时间（66.3±2.6）min]、失血量（59.3±13.9）mL]、住院时间（6.6±2.4）d]、负重时间（11.6±2.5）周]明显减少,与钢板固定组比较,差异有统计学意义（P〈0.05）。结论以正确方法使用钛合金弹性髓内钉治疗儿童四肢长骨干骨折,具有应力遮挡小、弹性大、损伤小、患肢功能恢复快、不影响骨骺、骨折愈合、并发症少等优点。

Curative effect of titanium elastic nails in the treatment of children with limbs long bone fracture

Objective To study the curative effect of titanium elastic nails（TEN） in the treatment of children with limbs long bone fractures.Methods From December 2008 to September 2011,45 cases of patients with limbs long bone fracture,who underwent open reduction plate fixation（plate fixation group） and titanium elastic intramedullary nail fixation（elastic intramedullary nail group） treatment respectively were selected.The mean surgery time,amount of blood loss,fracture X-ray healing time,hospitalization time,weight-bearing time of all the cases were recorded.Results 45 patients were followed-up in an average of 10.5 months.The average fracture healing time of plate fixation group was 14.5 weeks,which of the elastic intramedullary nail group was 9.8 weeks,the difference was statistically sig nificant（P 0.05）.Compared with the plate fixation group,the operation time （66.3±2.6） min],blood loss volume （59.3± 13.9） mL],hospitalization time （6.6±2.4） d],weight-bearing time （11.6±2.5） weeks] decreased significantly in the elastic intramedullary nail group,the differences were statistically significant（P 0.05）.Conclusion Based on the correct way to use titanium elastic intramedullary nail treatment for limbs long bone fractures in children,has advantages of small stress shelter,large flexibility,small injury,fast recovery of limb function,not affecting the epiphyseal and frac ture healing,fewer complications.