弹性髓内钉与接骨板治疗儿童股骨骨折的比较研究

目的 对采用弹性髓内钉及接骨板治疗儿童股骨骨折的操作情况、损伤情况、术后骨折愈合时间、并发症及功能恢复等情况进行比较.方法 2006年3月至2008年4月,随机将48例儿童股骨骨折的患儿分为两组,一组采用闭合复位、TEN固定,即TEN组;另一组采用切开复位、接骨板内固定治疗,即接骨板组.分别对两组患儿的一般资料,手术情况及术后并发症、功能恢复情况进行评估比较.结果 平均手术时间:TEN组34.6min,接骨板组58.4min;术中出血量:TEN组20.7 ml,接骨板组86.6 ml;平均切口长度:TEN组4.5 cm,接骨板组12.3 cm.所有病例均获随访,TEN组随访时间12～24个月(平均16.3个月).接骨板组随访时间13～23个月(平均17.8个月).TEN组平均愈合时间为8.4周;接骨板组为8.8周,两组比较无统计学差异.两组患儿均于术后12个月测量双下肢长度:TEN组双侧不等长平均6.8mm(2～15mm);接骨板组平均6.6mm(3～14mm),两组比较差异无统计学意义.根据Flynn等疗效评定标准:TEN组优良率为96.7%,接骨板组为94.4%,两者差异无统计学意义.结论 应用TEN和接骨板治疗儿童股骨骨折,在骨折愈合时间及术后功能方面无明显差异,但TEN较接骨板损伤小,操作简便,手术时间短.

Comparison of itanium elastic nails and blade plates for femoral fractures in children

Objective To compare and evaluate the bone union time,complications and function recovery of children with femur fractures treated by titanium elastic nails(TEN)and blade plates (BP).Methods Between 2006 and 2008,48 consecutive children with femur fractures,aging from 6 to15 years,were studied prospectively.They were divided into TEN group or BP group randomly,Thirty cases with the mean age of 8.5 years were treated by closed reduction of TEN,and the other 18 children with the mean age of 10.7 years were treated by open reduction of blade plates.The general data,operations,postoperative complications and function recovery of the two groups were compared and evaluated.Results All patients were followed-up with the average following-up period of 16.3 months(ranging from 12 to 24 months)in TEN group and 17.8 months(ranging from 13 to 23 months)in BP group.The mean operating time was 34.6 min in TEN group and 58.4 min in BP group.The mean bleeding was 20.7 ml in TEN group,while 86.6 ml in BP group.The mean length of incisions was 4.5 cm in TEN group,which was significantly shorter than that in BP group 12.3 cm,.The average bone union time was 8.4 weeks in TEN group and 8.8 weeks in BP group.Inequality between the lengths of the lower extremities were 2-15mm(menn 6.8 mm)in TEN group,and 3-14 mm(mean 6.6 mm)in BP group.According to the assessment criterion of therapeutic effect by Flynn,the total excellent and good rates were 96.7%and 94.4%in TEN and BP group,without significant diffeFence.Conclusions There is no significant difference of therapeutic effects between TEN and BP for children with femur fractures.However,TEN has obvious advantages in the aspects of less injury and shorter operating time than BP group.