小儿股骨干骨折的手术治疗及康复

Operative Treatment for Fractures of Femoral Shaft in Children and Rehabilitation

目的：探讨小儿股骨干骨折的手术治疗效果、併发症的预防及早期功能康复问题？椒？对245例小儿股骨干骨折的手术治疗方法及结果进行回顾性总结。髓内针固定80例,加压钢板固定130例,多枚螺钉加钢丝15例,髓内针加钢丝15例,多枚螺钉5例。结果：随访时间6个月～9年（平均6年零4个月）。所有骨折手术后6周～12周临床愈合。多枚螺钉固定一例术后2月再骨折,再次手术后3个月骨性愈合。一例针尾感染,经拔除髓内针和局部换药后愈合。无一例发生内固定弯曲、断裂;无一例发生骨不连、股骨头缺血性坏死、骺板早闭及功能障碍。结论：小儿股骨干骨折不应一律视为手术禁忌,只要病例选择合适,具有达到解剖复位、住院时间短、费用低、早期活动、功能恢复快等优点。但多枚螺钉内固定要慎用。

Objective：To discuss the effect of operative treatment for femoral shaft fracture in children,Prevention of complication and recovery problems of early functions. Methods： A retrospective summary of operative methods and results was made in 245 cases of fracture of femoral shaft in children. Intramedullary nails were used in 80 cases of 245 children,Compression-plate 130 caese,screws and steel wire 15 cases,Intramedullary nails and steel wire 15 cases and screws 5 cases. Results： The patients were followed up from 6 months to 9 years （averge 6 years and 4 months）. All of them obtained clinical heal in 6-12 weeks after operation. One of the multi-screw fixation was re-fracture two months after operation and bone union was acquired in 3 months after re-operation. An example needle tail infections,after partially trading the medicine and pulling out the needle to heal. There was no curving, breaking of the internal fixator,nonunion of the fracture,occurring ischemie necrosis of the femoral head,epiphseal plate＇s premature united and dysfunction. Conclusion：The operative treatment of femoral shaft in children should not be considered the contraindication. It had the advantages of anatomic reduction, short time of hospitalization,spending cheaply,allowing early Mobilization and fast function- recovery if patients are properly choieed and treated. But the multi- screw fixation should be used carefully.