骨骺滑动钢板固定复杂儿童股骨远端骨折

Pediatric physeal slide-traction plate for fixation of complex distal femoral fractures in children

[目的]探讨骨骺滑动钢板(pediatric physeal slide-traction plate,PPSP)在复杂儿童股骨远端骨折中的临床疗效。[方法]2018年3月—2020年3月,对20例复杂股骨远端骨折的患儿行手术治疗。分析围手术期、随访及影像资料。[结果]所有患儿均顺利完成手术,无严重并发症,随访时间均超过12个月。完全负重活动时间为9.5~12.0周,平均(10.7±0.5)周。术后随时间推移,膝HSS评分、膝屈-伸ROM显著增加(P<0.05);影像方面,所有患者股骨生长长度显著增加(P<0.05),双侧肢体长度差(LLD)、外侧股骨远端机械角(mLDFA)无明显改变(P>0.05);相应时间点,患侧与健侧股骨生长长度无明显差异(P>0.05)。[结论]PPSP固定可靠,不限制骨骺纵向生长,是治疗复杂儿童股骨远端骨折的有效选择。

[Objective]To explore the clinical outcomes of pediatric physeal slide-traction plate(PPSP)for internal fixation of complex distal femoral fractures in children.[Methods]From March 2018 to March 2020,20 children received open reduction and internal fixation with PPSP for complex distal femoral fractures.The perioperative,follow-up and imaging data were evaluated.[Results]All patients opera⁃tion performed smoothly without serious complications,and were followed up for more than 12 months.The time to resume full-weight bear⁃ing activity ranged from 9.5 to 12.0 weeks with an average of(10.7±0.5)weeks.The knee HSS score and ROM increased significantly over time after operation(P<0.05).In terms of imaging evaluation,the growth length of femur in all patients increased significantly(P<0.05),but the leg length discrepancy(LLD)and the mechanical lateral distal femord angle(mLDFA)remained unchanged significantly(P>0.05).At any corresponding time point,there was no significant difference in the femoral growth length between the affected side and the healthy side(P>0.05).[Conclusion]PPSP has the advantages of reliable fixation and no restriction on the longitudinal growth of epiphysis,which is an effective choice for the treatment of complex distal femoral fractures in children.