吴敏;官建中;陈笑天;王照东;高许斌;朱仲廉;

• 1:蚌埠医学院第一附属医院骨科组织移植安徽省重点实验室

摘要(Abstract)：

[目的]探讨评价闭合复位弹性髓内钉固定技术治疗儿童股骨转子下骨折的效果。[方法]2008年12月~2014年10月,采用闭合复位弹性髓内钉固定技术治疗21例股骨转子下骨折患儿。男15例,女6例;年龄4~12岁,平均7.7岁。左侧12例,右侧9例,致伤因素:交通事故伤13例,高处坠落伤7例,溜冰摔伤1例。均为新鲜闭合骨折。依据Seinsheimer分型:ⅡA型2例,ⅡB型7例,ⅡC型7例,ⅢB型3例,Ⅳ型2例。受伤至手术时间2~9 d,平均5.4 d。术后参照Flynn髓内钉治疗股骨骨折的评分标准评价术后患肢功能。[结果]手术时间25~60 min,平均32 min。术后患者切口均Ⅰ期愈合,无感染、无神经血管损伤等并发症发生。21例均获随访,随访时间18~56个月,平均24个月。术后3个月时骨折均达骨性愈合。随访期间无髓内钉折断、再骨折、骨骺早闭、股骨头缺血性坏死、下肢过度生长等并发症发生。1例SeinsheimerⅣ型患儿术后3个月骨折愈合后患肢较健侧短缩1.5 cm,随访30个月后双下肢等长。末次随访时,患肢功能按Flynn评定标准,获优19例,良2例,优良率100%。末次随访测量X线片有5例(23.8%,5/21)断端向前成角2°~8°,平均3.8°;3例(14.3%,3/21)向后成角2°~6°,平均4.0°;无内外翻成角。[结论]只要规范掌握复位及固定技巧,弹性髓内钉技术能够实现儿童股骨转子下骨折闭合复位及有效的固定,取得满意的手术效果,安全、微创,是一种理想的治疗方法。

关键词(KeyWords)： 儿童;股骨转子下骨折;弹性髓内钉;经皮

Abstract:

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作者(Author): 吴敏;官建中;陈笑天;王照东;高许斌;朱仲廉;

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参考文献(References)：

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