引用本文:张 敏,冯锡光,陈俊柱,邹建荣,黄明军,唐贵清,陈志文.弹性髓内针治疗儿童下肢长骨骨折的临床效果探讨[J].中国临床新医学,2020,13(9):924-927.
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弹性髓内针治疗儿童下肢长骨骨折的临床效果探讨
张 敏,冯锡光,陈俊柱,邹建荣,黄明军,唐贵清,陈志文
513000 广东,清远市英德市人民医院创伤骨科
摘要:
[摘要] 目的 探讨应用弹性髓内针治疗儿童下肢长骨骨折的临床效果。方法 选择该院2013-01~2019-12收治的34例下肢长骨骨折儿童作为研究对象,按照入院时间先后及手术方式不同,将2013-01~2017-02的17例采用切开复位钢板螺钉内固定的患者作为对照组,将2017-03~2019-12的17例采用闭合复位小儿弹性髓内针固定的患者作为观察组。比较两组治疗效果。结果 两组患者均获定期随访,随访时间为6~24个月。观察组骨折断端在术后4周拆除石膏时复查X线即可见到骨痂生成,髓内钉钉眼处均未见感染、松动、皮肤过敏等现象。观察组骨折平均愈合时间为(43.25±5.36)d,未见骨折不愈合,延迟愈合,未见骨折对线畸形,无肢体短缩,未见内固定物感染,6个月后随访所有患儿肢体活动功能恢复正常,骨折周围关节活动无受限。对照组骨折平均愈合时间为(70.49±8.41)d,3例骨折延迟愈合,2例内固定物感染,予再次手术后骨折愈合,未见骨折对线畸形及肢体短缩畸形。观察组手术时间、出血量、住院时间及骨折愈合时间均短于或少于对照组(P<0.05)。观察组疗效优于对照组(P<0.05)。结论 弹性髓内针应用于儿童下肢长骨骨折效果显著,值得临床推广。
关键词:  儿童  下肢  长骨骨折  弹性髓内针
DOI:10.3969/j.issn.1674-3806.2020.09.19
分类号:R 683.42
基金项目:
Clinical effect of elastic intramedullary needle on treatment of long bone fractures of lower limbs in children
ZHANG Min, FENG Xi-guang, CHEN Jun-zhu, et al.
Department of Traumatology and Orthopedics, Yingde City People′s Hospital, Qingyuan City, Guangdong 513000, China
Abstract:
[Abstract] Objective To explore the clinical effect of applying elastic intramedullary needle(ESIN) on treatment of long bone fractures of lower limbs in children. Methods Thirty-four children with long bone fractures of lower limbs treated in our hospital from January 2013 to December 2019 were selected as the research subjects. The 34 patients were divided into observation group and control group according to the time sequence of admission and different operation methods, among whom 17 cases receiving open reduction and plate screw internal fixation during January 2013 and February 2017 were taken as the control group, and the other 17 cases receiving closed reduction and ESIN fixation during March 2017 and December 2019 were taken as the observation group. The treatment effects were compared between the two groups. Results Both groups were regularly followed up for 6 to 24 months. In the observation group, when the plaster was removed 4 weeks after operation, the formation of callus of bone could be seen on the fracture ends by X-ray, and no infection, looseness and skin allergy were found at the nail holes of the intramedullary nails. The average healing time of the fractures in the observation group was (43.25±5.36)days. No fracture nonunion and delayed union, no deformity of fracture alignment, no shortening of the affected limbs and no infection of the internal fixations were found. Six months after operation, all the children were followed up and their limb activity returned to normal, and the joint activity around the fractures was not limited. In the control group, the average healing time of the fractures was (70.49±8.41)days; three cases had delayed unions, and 2 cases had internal fixation infections, and the fractures healed after reoperation; no deformity of fracture alignment and limb shortening deformity were found. The operation time, hospitalization time and the fracture healing time of the observation group was significantly shorter than that of the control group(P<0.05). The amount of bleeding in the observation group was significantly less than that in the control group(P<0.05). The clinical effect of the observation group were significantly better than those of the control group(P<0.05). Conclusion The application of elastic intramedullary needle is significantly effective in treatment of long bone fractures of lower limbs in children, which is worthy of clinical promotion.
Key words:  Children  Lower limbs  Long bone fracture  Elastic intramedullary needle(ESIN)