儿童长骨骨折不愈合原因分析与治疗

Non-union of long bone fractures in children

目的探讨引起儿童长骨骨折不愈合的相关因素，为临床规避相关风险提供借鉴。方法回顾1996至2006年收治的儿童长骨骨折不愈合病例51例，从损伤原因、骨折部位、治疗方法等方面分析引起骨折不愈合的原因，并采用更换固定方式、植骨等手术方法对骨折不愈合病例进行重新治疗。结果51例病例经更换内固定为髓内固定或采用外固定架加植骨等治疗方法均获得良好愈合，在随访期内未发生再骨折。结论儿童长骨骨折治疗不当是引起骨折不愈合的主要原因，高能量损伤也是引起骨折不愈合的原因之一；在骨折部位方面，本组病例中以股骨干骨折不愈合多见。对于儿童长骨骨折不愈合的治疗应该在诊断明确后尽早更换固定方式，骨折端重新获得稳定是治疗的关键。

Objective To review the causes of non-union of long bone fractures in children. Methods Fifty-one children with non-union of long bone fracture managed in our department between 1996 and 2006were reviewed. We investigated the causes of non-union according to injury type, fracture location and treatment methods. We treated the non-union by intramedullary or external fixation and bone graft. Results Fifty-one cases of non-union of long bone fracture healed by replacing internal fixation to intramedullary or external fixation and bone grafting. No refracture was detected during follow-up. Conclusions Improper treatment for long bone fracture in children is the main reason of non union. High-energy injury is additional cause.