组合式外固定架治疗儿童长骨干骺端骨折

Treatment of long bone metaphyseal fracture in children with combined external fixator

目的探讨应用组合式外固定架治疗儿童长骨干骺端骨折的临床效果。方法回顾性分析2011年1月-2017年12月应用组合式外固定架治疗的84例儿童长骨干骺端骨折资料,均采用闭合复位(开放性骨折除外)组合式外固定架固定,于长骨干骺端接近骨骺的骨折端垂直骨干长轴置入1枚直径2.5~3.5 mm的全针固定,连接半环弓,而后置入适当数目的半钉与连接杆连接固定。结果术后所有患儿均获得随访,随访时间12~36个月,平均20个月,骨折愈合时间6~8周,术后均无严重并发症发生,无骨骺生长障碍及肢体畸形。结论组合式外固定架治疗儿童长骨干骺端骨折,创伤小、骨折愈合快、并发症少,无需二次手术,可早期功能训练,疗效满意。

Objective To investigate the clinical effect of combined external fixator in the treatment of metaphyseal fracture of long bone in children. Methods A retrospective analysis was made in 84 cases of children’s metaphyseal fracture treated with combined external fixator from January 2011 to December2017. All cases were fixed with closed reduction(except open fracture) combined with external fixator. A2.5-3.5 mm diameter Stephen’s pin was inserted into the long axis of the fracture near the metaphyseal end of the long bone to connect the semicircular arch, and then a proper number of semi-nail was inserted. The semi-nail is connected and fixed with the connecting rod. Results All patients were followed up for 12 to 36 months, with an average of 20 months. The fracture healing time was 6 to 8 weeks. There were no serious complications, epiphyseal growth disorders and limb deformities.Conclusion Combined external fixator for the treatment of children’s metaphyseal fracture of long bone has the advantages of less trauma, faster fracture healing and fewer complications. It does not need second operation and can perform early functional exercises with satisfactory results.