儿童四肢长骨干闭合骨折不同治疗方法的疗效比较

Comparison of effects among different treatment methods for closed fracture of limb long bone shaft in children

目的比较儿童四肢长骨干闭合骨折采用非手术治疗、钢板及弹性钉治疗的疗效。阐述弹性钉治疗儿童骨折的优点。方法自2004年7月～2011年6月治疗4～11岁的四肢长骨干闭合骨折288例，行非手术治疗者56例。钢板治疗者98例。弹性钉治疗者134例，比较非手术与弹性钉治疗骨折、钢板与弹性钉治疗骨折的疗效情况。结果非手术组与弹性钉组在骨折愈合时间、肢体长度及关节功能方面差异无统计学意义，但在成角畸形及骨折再移位方面非手术组高于弹性钉组。钢板组在切口长度、手术时间、骨折愈合时间方面高于弹性钉组。关节功能恢复较差。结论对完全移位的儿童四肢长骨干闭合骨折采用闭合复位弹性钉治疗具有操作简单、创伤小、愈合快、预后好的优点，应作为首选的治疗方法。

Objective To compare the clinical effects in conservative treatment, plate treatment and titanium elastic nail treatment in the therapy of limb long bone shaft closed fracture in children and to elaborate advantages of titanium elastic nailing in the treatment of children＇s fractures. Methods A total of 288 cases in children of closed fracture of long bone shaft were treated from July 2004 to June 2011. They were all followed up, including 56 cases of conservative treatment, 98 eases of steel treatment and 134 cases of titanium elastic nail treatment. The clinical effects in conservative treatment with titanium elastic nail treatment and the effects in plate treatment with titanium elastic nail treatment in the therapy of fractures in children were compared. Results There were no significant differences between the conservative treatment group and titanium elastic nail treatment group in fracture healing time, limb length and joint function. But the occurrence of angular deformity and fracture re-displacement was higher in the conservative treatment group than in the elastic nail treatment group. The plate treatment group was longer than titanium elastic nail treatment group in the parts of length of incision, operation time and fracture healing time, the joint function was also poorer. Conclusion To cure the completely displaced children＇s long bone shaft closed fracture, the advantages of closed reduction titanium elastic nails are simple operation, minimal invasion, faster healing and better prognosis. So it should be used as the preferred method of treatment.