可吸收内固定在儿童胫腓骨骨折中的应用

Internal bioabsorbable fixation for the treatment of the tibiofibula fractures in children

目的探讨可吸收植入物在儿童胫腓骨骨折中的应用及临床疗效。方法2011年1月至2012年1月20例儿童胫腓骨骨折行切开复位，远端斜形及螺旋形骨折应用可吸收内固定螺钉固定，中端斜形及螺旋形骨折行弹性髓内钉结合可吸收螺钉固定，远端骨骺骨折行可吸收骨棒或螺钉固定。术后定期复查X线片，对骨折愈合及临床功能恢复行回顾性分析总结。结果随访6个月～1年，骨折全部愈合。1例胫骨中端粉碎骨折行弹性髓内钉结合可吸收螺钉固定，术后2个月复查骨痂生长缓慢，更换短腿支具后下地负重锻炼，6个月后复查骨痂生长丰富。结论可吸收螺钉及棒应用于儿童胫腓骨骨折临床疗效明确，避免二次手术，减少儿童创伤及痛苦，可作为儿童胫骨中远端斜形及螺旋形骨折、远端骨骺骨折首新考虑的有效内固定方法。

Objective To explore the availability and feasibility of the bioabsorbable fixation to treat tibiofibula fractures in children. Methods Twenty patients with tibiofibula fractures underwent internal absorbable fixation in this institute from January 2011 to January 2012. The distal tibiofibula fractures were fixed with bioabsorbable screws, while the midpiece fractures of tibiofibula were fixed with bioabsorbable screws combined with elastic intramedullary nail. Distal tibial epiphyseal fractures were fixed using bioabsorbable spiral and pin. Fracture healing and functional recovery were followed up after surgery. Results Follow-up period was 6 to 12 months. All fractures were healed. One pa- tient ~s tibia comminuted fracture was fixed with absorbable elastic intramedullary nail, and postopera- tive X-radiogram suggested bony callus formed slower than average during follow-up. However, con- tinuous weight-bearing exercises accelerated bony callus formation and a mass of bony callus was found on the X-radiogram 6 months after surgery. Conclusions The bioabsorbable internal fixation is safe and effective for the treatment of tibiofibula fractures in children.