小儿髋部加压锁定板治疗儿童股骨粗隆部骨折的效果

Effect of locking compression paediatric hip plate applicated in the treatment of femoral inter and subtrochanteric fractures in children

目的观察股骨近端外侧切开复位小儿髋部加压锁定板(LCP PHP)内固定治疗小儿股骨粗隆部骨折的临床效果。方法选取2010年8月~2016年3月北京积水潭医院使用LCP PHP钢板治疗的26例股骨粗隆部骨折患儿作为研究对象,观察指标包括使用Beaty标准影像学评估法评估影像学资料,骨折骨性愈合时间,并发症发生情况,髋关节功能按Sanders标准评定。结果共16例患儿获得满意随访,平均随访时间10[7.25,13.75]个月,16例患儿术后影像学资料评估全部为满意,14例患儿经过X线摄片提示骨折正常骨性愈合,平均骨性愈合时间为11[7.75,16.00]周,随访中未见并发症发生,1例股骨粗隆下骨折合并多发骨折患儿因骨折延迟愈合出现内固定断裂,后期采用肱骨近端外侧钢板(Philos系统)内固定治疗获得骨性愈合,1例股骨粗隆间骨折因愈合不良导致内固定失效,出现髋内翻,16例患儿髋关节功能评定12例优,3例良,1例中,其中11例单纯股骨粗隆间或粗隆下骨折髋关节功能评定均为优。结论 LCP PHP内固定系统治疗儿童股骨粗隆部骨折,术后内固定稳定,骨折愈合快,术后并发症少,可适当缩短外固定佩戴时间,便于早期功能锻炼恢复髋关节功能,临床应用价值大。

Objective To observe the clinical effect of the lateral reduction of proximal femur and internal fixation with locking compression paediatric hip plate(LCP PHP)for the treatment of femoral inter and subtrochanteric fractures in children.Methods There were 26 cases of femoral inter and subtrochanteric fracture treated with LCP PHP plate in Beijing Jishuitan Hospital from August 2010 to March 2016 were selected as study object.Beaty standard imaging evaluation methods were used for evaluation of imaging data,fracture healing time and complications were recorded,and hip function was evaluated according to Sanders standard.Results A total of 16 patients were followed up satisfactorily with an average follow-up time of 10(7.25,13.75)months.All the 16 patients were satisfied with the postoperative imaging data.14 patients had normal bone healing through X-ray examination results.The average healing time was 11(7.75,16.00)weeks.No complications occurred during follow-up.One patient with femoral subtrochanteric fracture combined with multiple fractures had internal fixation fracture due to delayed union of fracture,and the proximal humerus lateral plate(Philos system)internal fixation was used laterally to obtain bone healing.One patient of intertrochanteric fracture due to poor healing lead to failure of internal fixation,leading to coxa varus.About hip function,12 cases were excellent,3 were good,and 1 was middle of the 16 cases;among the 16 cases,11 cases of intertrochanteric or simple subtrochanteric fracture were all excellent in hip joint function.Conclusion LCP PHP internal fixation system is used to treat the femoral inter and subtrochanteric fractures in children.The postoperative internal fixation is stable,the fracture healing is fast,and the postoperative complications are less.It can shorten the time of external fixation and facilitate the early functional exercise to restore the hip function,with high clinical value.