弹性髓内钉在儿童不稳定胫骨干骨折治疗中的应用

The Application of Elastic Intramedullary Nails to Treat the Unstable Pediatric Tibial Shaft Fractures

目的探讨采用弹性髓内钉内固定治疗儿童不稳定胫骨干骨折的疗效。方法 23例胫骨骨折的儿童患者,男13例,女10例;年龄4~12岁,平均8.4岁。均采用弹性髓内钉固定,观察骨折愈合情况。结果本组病例均获6-24个月随访,平均16.4个月,无一例发生切口并发症,无继发骨折移位及内固定物失效或断裂。23例骨折全部愈合,骨愈合时间7~13周（平均9.2周）。无延迟愈合、骨不连,无旋转畸形及下肢短缩或过度生长,l足出现向前成角5,°1足向内成角7,°无骺板生长阻滞及术后再骨折发生,无膝、踝关节功能障碍。结论弹性髓内针具有手术时间短、创伤小、并发症少、二期取出方便等优点,是治疗儿童不稳定胫骨干骨折的较好方法。

Objective To assess the application of elastic intramedullary nails to treat the unstable pediatric tibial shaft fractures.Methods 23 cases of unstable pediatric tibial shaft fractures were treated using elastic intramedullary nail.Results All the patients were followed up for an average period of 16.4 months（range 6 to 24 months）.23 cases of tibial shaft fracture were all cured.average healing time was 9.2 weeks（range 7 to 13 weeks）.Complications included delayed union,non-union,leg length discrepancy,rotational deformity were not occurred One patient had apex anterior angulation measuring 5 degrees,one patient had 7 degrees of valgus malalignment.Osteoepiphystic lamine growth block and refracture in postoperation also were not seen.No patient reported knee pain or had any loss of motion at the knee or ankle.Conclusion Elastic intramedullary nails has the advantages of short operation time,minimally invasive,few complications and convenient removal of the nailing.It is an effective method of internal fixation for treating unstable pediatric tibial shaft fractures.