弹性髓内钉及锁定加压钢板治疗儿童股骨近段骨折的临床对比研究

Comparision between titanium elastic nails(TEN) and locking compression plate(LCP) internal fixation for pediatric proximal femoral fracture

[目的]对比弹性髓内钉与锁定加压钢板治疗儿童股骨近段骨折的临床疗效,并分析两者的优缺点。[方法]收治不同年龄儿童股骨近段骨折63例,其中采用弹性髓内钉35例,锁定加压钢板28例,记录手术时间、术中失血量、术后并发症、术后6周、6、24个月Harris髋关节功能评分,并进行比较。[结果]随访18～39个月,所有病例均获得骨性愈合。锁定加压钢板组术后6周可有良好的Harris评分,但是在手术时间上及术中失血量上比较均高于弹性髓内钉组,术后并发症、6个月后的Harris评分两者无明显差异。[结论]不同年龄儿童股骨近段骨折可依据患儿年龄、体重、骨折稳定性选择弹性髓内钉或锁定加压钢板治疗,均可取得良好临床疗效。

[ Objective ] To compare the treatment of pediatric proximal femoral fracture by titanium elastic nails （TEN） and locking compression plate（LCP）. [Method] Sixty-three various ages children with proximal femoral fracture were divided into two groups,35 cases were fixed with TEN, the others were treated with LCP. The duration of operation,the intra operation blood loss ,the ratio of complications and Harris score in 6 weeks ,6 and 24 months postoperatively were compared between two groups. [ Result] The time of follow up were 18 to 39 months in all 63 patients and all the fractures healed well. The Harris score of hip joint at 6 weeks post-operatively was higher in the LCP group（P 〈0.05） ,but the duration of operation and the intra-operation blood loss were bighter than those in TEN group. The ratio of complications and the score of the two groups had no significant difference at 6 months and 24 months. [ Conclusion] The treatments by TEN and LCP for proximal femoral fracture in various a- ges children are chosen according to children＇s age, weight and stability of tracture. These two kinds of treatment will obtain very good clinical effect.