手术时机超过24小时的儿童股骨颈骨折手术疗效分析

目的 探讨不同手术方式对手术时机已超过24 h的儿童股骨颈骨折的临床疗效，并分析相关并发症的影响因素。方法 回顾性分析2015年1月至2017年10月安徽省儿童医院骨科收治的78例股骨颈骨折患儿的资料。根据手术方法的不同，将患儿分为闭合复位组（53例）与切开复位组（25例）。评估两组患儿的手术时间、骨折愈合情况、Ratliff评定、骨折愈合时间的差异，并评估两组患儿并发症的发生情况，比较其预后。结果 闭合复位组患儿手术时间为（80.15±32.78） min，少于切开复位组的（112.80±48.49） min，差异有统计学意义（P<0.05）。两组患儿Ratliff评定、骨折愈合情况比较，差异无统计学意义（P>0.05）。切开复位组患儿的并发症发生率（20.00%）较闭合复位组（47.16%）低，差异有统计学意义（P<0.05）。结论 对于手术时机超过24 h的儿童股骨颈骨折，切开复位治疗的并发症发生率更低，切开复位是较理想的手术方式。

Comparison of surgical effect of children femoral neck fracture with late-treatment time exceeding 24 hours

Objective To compare the results and complications of different internal fixation in late-treatment of femoral neck fracture in children. Methods From January 2015 to October 2017,78 children with late-treated femoral neck fracture admitted to Anhui children''s Hospital were selected. According to the different surgical methods, the children were divided into closed reduction group (53 cases) and open reduction group(25 cases).The differences between two groups in operation time, fracture healing, Ratliff assessment, and fracture healing time were assessed, and the incidence of complications in two groups was evaluated and their prognosis was compared accordingly. Results The operation time in closed reduction group was less than that in open reduction group, and the difference was statistically significant(P<0.05).Ratliff evaluation and fracture healing were compared between two groups, and the differences were not statistically significant(P>0.05).The incidence of complications in open reduction group(20.00%) was lower than that in closed reduction group (47.16%),and the difference was statistically significant (P<0.05).Conclusions The incidence of complications in open reduction group is lower than that in closed reduction group,so open reduction is the better operative method for children with late-treatment femoral neck fracture.