弹性髓内钉固定与单纯石膏外固定治疗儿童稳定性胫骨骨折的比较

Comparison of titanium elastic nails fixation and plaster external fixation for stable tibial fractures in children

目的 比较弹性髓内钉（TENs）内固定与单纯石膏外固定治疗儿童胫骨稳定性骨折的疗效。方法 回顾性分析76例稳定性胫骨骨折患儿,49例患儿采用TENs治疗（TENs组）,27例患儿采用保守治疗,闭合复位石膏外固定（外固定组）。76例均获得6月以上的随访。结果 所有患者随访6-14个月,平均10个月。TENs组骨折均愈合。根据Flynn评价标准,优良率达到100%。外固定组有11例患儿复查过程中出现骨折断端移位明显,单纯石膏外固定失败改行手术治疗。优9例,良7例,差11例,优良率为59.2%。两组差异有统计学意义（P〈0.05）。结论 外固定治疗胫骨稳定性骨折易造成骨折端再移位,治疗效果较差。而TENs固定治疗儿童胫骨骨折不易再移位,是治疗儿童胫骨骨折的理想方法。

Objective To compare the effects of titanium elastic nails（TENs）fixation and simple plaster external fixation for the treat-ment of children with stable tibial fractures.Methods We retrospectively analyzed 76 cases of stable tibial fractures.49 cases were treated with TENs（TENs group）,while another 27 cases were treated with closed reduction and plaster external fixation（external fixa-tion group）.All of the cases were all followed up for over 6 months.Results All the patients were followed up for an average period of 10 months（ranging 6 to 14 months）.Patients in TENs group were all cured.According to the Flynn evaluation criteria,the excellent and good rate was 100%.In the external fixation group,11 cases failed with simple plaster external fixation,then changed to undergo surger-y.Nine cases were excellent,7 cases were good,and 11 cases were poor.The excellent and good rate was 59.2%.The difference be-tween the two groups was statistically significant（P 〈0.05）.Conclusions External fixation for the treatment of stable fracture of the tibia is likely to fail with a poor efficacy.The TENs fixed treatment of tibial fractures in children is not likely to retransfer,which is an ideal treatment for children with stable tibial fractures.