跨骨骺滑动钢板固定治疗复杂儿童股骨远端骨折的近期临床报告

Short-term Clinical Report of the Slide-traction Fixation Beyond Physeal in the Treatment of Complicated Distal Femur Fratcure of Children

目的观察跨骨骺滑动钢板固定治疗复杂儿童股骨远端骨折的近期疗效,为跨骨骺滑动钢板治疗复杂儿童股骨远端骨折提供依据。方法自2008年6月～2010年6月,应用跨骨骺滑动钢板治疗13例复杂儿童股骨远端骨折,术后1、3、6个月对照健侧测量患肢力线、生长情况和观察骨折愈合情况;膝关节功能采用Schatzker-Lambert股骨远端骨折功能评分评价疗效。结果所有患者获得6～10个月(平均8.7个月)随访,未见骨折再移位和内固定物断裂,所有的骨折均获得愈合,平均愈合时间为7.5周,影像学观察见滑动钢板随骺板生长发育而相应延长,平均滑动长度10.96 mm,无成角短缩畸形;Schatzker-Lambert股骨远端骨折功能评分:优7例,良5例,可1例。结论跨骨骺滑动钢板既可为骨骺损伤提供可靠的固定,又不会对骨骺生长产生纵向抑制,为复杂儿童股骨远端骨折提供一种安全有效的新方法。

Objective To observe the short-term clinical effect of the slide-traction plate beyond physeal in the treatment of complicated distal femur fratcure of children and providing clinical data for safe clinical practice of the slide-traction plate in complicated distal femur frateure of children. Methods Between June 2008 and June 2010, 13 cases of complicated distal femur fratcure of children were treated with the slide-traction plate. Their clinical and radiographic outcomes were collected to compare the differences in lower extremity alige- ment and length with control lateral and bone union were observed at 1,3,6 months after operation. Schatzker-Lambert functional score system was used to evaluate knee joint function. Results The average follow-up was 8.7 months （6 to 10 months）. Removent of fratcures and broken of plates were no found. All patients had bone union at an mean time of 7.5 weeks. Radiographic examination showed the length of the slide-traction plate beyond physeal got an average 10.96 mm increase along with the epiphyseal growth. Shortening and an- gulation deformity was not found in all patients. Schatzker-Lambert functional score system of distal femur fracture showed 7 cases were excellent, 5 good and 1 fair. Conclusion This study indicates that the slide-traction plate beyond physeal not only affordes stable fixa- tion for fracture, but also reduces longitude growth restraint of epiphysea. So it can supply an safe and effective treatment of complicated distal femur fratcure in children.