双S形弹性髓内钉在儿童胫骨远端干骺交界区骨折中的应用效果分析

Double S-shaped elastic stable intramedullary nailing to treat pediatric fractures of the distal tibia diaphyseal metaphyseal junction

目的探讨双S形弹性髓内钉在儿童胫骨远端干骺交界区骨折中的应用效果。方法回顾性分析2018年1月至2022年1月内蒙古医科大学第二附属医院儿童骨科治疗的25例儿童胫骨远端干骺交界区骨折患者资料,所有患儿均使用闭合复位双S形弹性髓内钉内固定术治疗。男16例,女9例;年龄(10.4±3.3)岁;左侧14例,右侧11例;术后记录手术时间、影像学结果、并发症发生情况。末次随访时采用采用美国足踝外科协会(AOFAS)评分评定疗效。结果所有患者均成功闭合复位,手术时间为(55.6±23.7)min;所有患者术后获(20.5±4.7)个月随访。所有患儿术后均达到骨性愈合,骨折愈合时间为(11.5±2.7)周。术后所有患者均未发生切口感染、复位丢失、双下肢不等长、骨折延迟愈合或不愈合等并发症。末次随访时采用AOFAS评分评定踝关节功能疗效:优23例,良2例,优良率100%(25/25)。结论双S形弹性髓内钉内固定治疗儿童胫骨远端干骺交界区骨折安全、有效,是一种可行的治疗方式。

Objective To investigate the efficacy of double S-shaped elastic stable intramedullary nailing in the treatment of paediatric fractures of the distal tibia diaphyseal metaphyseal junction.Methods From January 2018 to January 2022,a total of 25 children with fracture of the distal tibia diaphyseal metaphyseal junction were treated at Department of Pediatric Orthopedics,The Second Affiliated Hospital of Inner Mongolia Medical University.All of them were treated with closed reduction and double S-shaped elastic stable intramedullary nailing.There were 16 males and 9 females with an average age of(10.4±3.3)years,and 14 left sides and 11 right sides.The operation time,imaging results and complications were recorded after operation.At the last follow-up,the American Orthopaedic Foot&Ankle Society(AOFAS)scoring was used to evaluate the efficacy.Results Closed reduction succeeded in all patients.The operation time was(55.6±23.7)min.Follow-up lasted(20.5±4.7)months for this cohort.Bony union was achieved in all patients after(11.5±2.7)weeks.No postoperative complications occurred in the patients,like infection,loss of reduction,disparity in length of lower limbs,delayed union or non-union.The AOFAS scoring at the last follow-up yielded 23 excellent and 2 good cases,and an excellent and good rate of 100%(25/25).Conclusion In the treatment of paediatric fractures of the distal tibia diaphyseal metaphyseal junction,double S-shaped elastic stable intramedullary nailing is a safe,effective and feasible option.