弹性髓内针在儿童四肢骨折中的应用

Application of elastic intramedullary nailling in pediatric long bone fractures

目的采用弹性髓内针治疗儿童四肢骨折并分析其疗效。方法回顾性分析本院2005年9月至2008年3月采用弹性髓内针治疗172例儿童四肢骨折，其中肱骨骨折16例，尺桡骨骨折31例，股骨骨折78例，胫骨骨折47例。结果随访全部病例，随访时间6～30个月，平均14个月。术后愈合优165例（95．93％），良7例。172例全部Ⅰ期愈合，无骨感染和骨不连发生，无术后断针、再移位及拔针后再骨折现象。结论弹性髓内针固定是一种安全、简便、快速的儿童长骨干骨折的治疗方法，特别适合于儿童的四肢长骨骨折，与传统的夹板或石膏固定或切开复位技术相比，它具有皮肤组织损伤小、不损伤骺板、不影响骨髓内部的血液循环、骨折愈合恢复快、住院周期短、患儿易耐受等优点，是目前治疗儿童四肢骨折的理想方法。

Objective To study the application of elastic intramedullary nails to treat the pediatric limbs long hone fractures,and assess the curative effect. Methods Through retrospective analysis 172 cases of pediatric limbs long bone fractures had been treated with elastic intramedullary nailing in our hospital,between 2005.9-2008.3. In this group there were 16 cases were humerus fractures,31cases were rule or radius fractures,78 cases were femur fractures and 47 cases were tibia fractures. We reviewed the union of fractures and the condition of function. Results 172 cases all have been followed up over 6 months to 30 months,the average was 1 years and 2 months. 165 cases were recovery excellent（the rate was 95.93%）,7 cases were fine. All of them were primary heal ing,none of them has bone infection or bone un union. All of them have not found nails breakdown, fractures displace again or re fracture after removed the nails. Conclusion Flexible intramedullary nails crossing fixation is a safe,convenient and volant therapy method for pediatric long bone fractures,especially for limbs long bone fractures,so it is effective therapeutic approach,as limbs long bone transaction fractures.multi-section and complex injury. Compared to the orthodox technique as epithesis or gypsum fixation or open reduction, this technique has many fortes, such as small skin wound, tiny tissue damage, not damage the epiphyseal plate, not influence blood circulation in marrow, fractures recovery fast, short period in hospital, the nails pull out convenience and child easy tolerance. So it is effective therapeutic approach for pediatric limbs long bone fractures.