儿童股骨干骨折手术治疗的探讨

Operative Treatment for Fracture of Femoral Shaft in Children.

目的 :探讨儿童股骨干骨折的三种内固定手术治疗效果。方法 :对 5 0例儿童股骨干骨折的手术治疗方法及结果进行回顾性总结。结果 :髓内针固定 16例 ,钢板螺钉固定 2 3例 ,多枚螺钉固定 11例。所有骨折于术后 4～ 8周临床愈合 ,1例术后 6个月钢板断裂 ,其他病例均于术后 4～ 12个月 (平均 6 .5个月 )骨性愈合后取出内固定物。随访时间 1～ 8年 (平均 4.5年 ) ,与手术有关的并发症有钢板断裂、再骨折、晚期扁平髋各 1例 ,占 6 %。结论 :髓内针固定操作简单 ,适于股骨上、中段骨折 ,但选择时需慎重 ;钢板螺钉固定对骨折复位满意 ,固定确切 ,适于复杂股骨干骨折 ,但创伤大 ;

Objective: To discuss the effect of three kinds internal fixation technology for femoral shaft fracture in children.Methods:A retrospective summary of different methods and results were made in 50 cases of fracture of femoral shaft in children.Results:Intramedullary nails were used in 16 cases of 50 children,plates 23 cases and screws 11 cases.All of them obtained clinical heal in 4～8 weeks after operation.Plate broken occured in one case 6 months after operation,the implants were removed out within 4～12 months(average 6.5 months)after operation.The follow-up periods was 1 to 8 years(average 4.5 years),6% of complication correlated with operation occured, such as plate broken,refracture and coxa plana one case each.Conclusion:Intramedullary nail technology was simple and applicable to upper or middle parts fracture of femoral shaft.But proper selection should be emphasized.The plate was satisfied for complex fracture,but it may make additional injury to patients.Screws was applicable in treatment for long oblique or helical fracture.