[1]赵志强,闫鹏飞,牛珊珊,等.微创弹性髓内钉内固定与切开复位锁定加压钢板内固定治疗小儿股骨干骨折疗效比较[J].新乡医学院学报,2019,36(3):254-257.[doi:10.7683/xxyxyxb.2019.03.012]
　ZHAO Zhi-qiang,YAN Peng- fei,NIU Shan-shan,et al.Comparisons of the effect between minimally invasive elastic intramedullary nail internal fixation and locking compression plate internal fixation after open reduction in the treatment of femoral shaft fractures in children[J].Journal of Xinxiang Medical University,2019,36(3):254-257.[doi:10.7683/xxyxyxb.2019.03.012]
点击复制

微创弹性髓内钉内固定与切开复位锁定加压钢板内固定治疗小儿股骨干骨折疗效比较
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年3
页码:
254-257
栏目:
临床研究
出版日期:
2019-03-05

文章信息/Info

Title:
Comparisons of the effect between minimally invasive elastic intramedullary nail internal fixation and locking compression plate internal fixation after open reduction in the treatment of femoral shaft fractures in children
作者:
赵志强; 闫鹏飞; 牛珊珊; 赵鹏举; 何　巍
（新乡医学院第一附属医院小儿外科，河南　卫辉　453100）
Author(s):
ZHAO Zhi-qiang; YAN Peng- fei; NIU Shan-shan; ZHAO Peng-ju; HE Wei
(Department of Pediatric Surgery,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
儿童; 股骨干骨折; 微创手术; 弹性髓内钉内固定术; 切开复位; 锁定加压钢板固定术
Keywords:
children; femoral shaft fractures; minimally invasive surgery; elastic intramedullary nail internal fixation; open reduction; locking compression plate internal fixation
分类号:
R726.8
DOI:
10.7683/xxyxyxb.2019.03.012
文献标志码:
A
摘要:
目的　比较微创弹性髓内钉内固定与切开复位锁定加压钢板内固定治疗小儿股骨干骨折（FSF）的临床效果，探讨小儿FSF的最佳手术方式。方法　选择2013年1月至2017年12月新乡医学院第一附属医院收治的60例FSF患儿为研究对象，根据治疗方法分为观察组和对照组，每组30例。观察组患儿采用牵引复位后微创弹性髓内钉内固定治疗，对照组患儿采用切开复位锁定加压钢板内固定治疗。记录2组患者手术时间和术中出血量；术后随访6个月，记录患者骨折临床愈合时间、骨性愈合时间和并发症。术后6个月，采用Kolmert评分评价2组患儿的临床疗效。结果　观察组患儿手术时间显著短于对照组（t=6.208,P<0.05），术中出血量显著少于对照组（t=5.273，P<0.05）。观察组患儿骨折临床愈合时间显著短于对照组（t=5.508，P<0.05），骨性愈合时间也显著短于对照组（t=4.372，P<0.05）。观察组和对照组患儿治疗效果优良率分别为83.33%（25/30）、63.33（19/30），观察组患儿治疗效果优良率高于对照组（χ2=4.743，P<0.05）。观察组和对照组患儿并发症发生率分别为3.33%（1/30）、20.00%（6/30），观察组患儿并发症发生率低于对照组（χ2=3.875，P<0.05）。结论　微创弹性髓内钉内固定治疗小儿FSF具有手术时间短、术中出血量少、骨折愈合快、并发症少等优势。
Abstract:
Objective　To compare the clinical effect of minimally invasive elastic intramedullary nail internal fixation and locking compression plate internal fixation after open reduction in the treatment of femoral shaft fracture (FSF) in children,and to investigate the best surgical method for FSF in children.Methods　Sixty children with FSF in the First Affiliated Hospital of Xinxiang Medical University from January 2013 to December 2017 were selected as the study subjects.The patients were divided into observation group and control group according to the treatment method,30 cases in each group.The children in the observation group were treated with minimally invasive elastic intramedullary nail internal fixation after traction reduction,while the children in the control group were treated with locking compression plate internal fixation after open reduction.The operation time and intraoperative bleeding volume of children in the two groups were recorded.All children were followed up for 6 months,and the clinical healing time,bone healing time and complications were recorded.The clinical efficacy of children in the two groups was evaluated by Kolmert score at six months after operation.Results　The operation time of children in the observation group was significantly shorter than that in the control group (t=6.208,P<0.05),and the intraoperative bleeding volume of children in the observation group was significantly less than that in the control group (t=5.273,P<0.05).The clinical healing time of children in the observation group was significantly shorter than that in the control group (t=5.508,P<0.05),and the bone healing time of children in the observation group was significantly shorter than that in the control group (t=4.372,P<0.05).The fineness rate in the observation group and control group was 83.33% (25/30) and 63.33 (19/30),respectively.The fineness rate in the observation group was higher than those in the control group (χ2=4.743,P<0.05).The incidence of complications in the observation group and control group was 3.33% (1/30) and 20.00% (6/30),respectively.The incidence of complications in the observation group was lower than that in the control group (χ2=3.875,P<0.05).Conclusion　Minimally invasive elastic intramedullary nail internal fixation for FSF in children has the advantages of shorter operation time,less intraoperative bleeding,faster fracture healing and fewer complications.

参考文献/References:

［1］　徐会法，黄鲁豫，雷伟，等.钛制弹性髓内钉固定治疗儿童股骨干长螺旋形骨折［J］.中华创伤骨科杂志，2014，16（2）：137-140.
［2］　闫军，周劲松，李雷，等.闭合复位加长型股骨近端防旋髓内钉内固定治疗股骨干骨折合并同侧股骨粗隆间骨折［J］.中国微创外科杂志，2015，15（2）：163-166.
［3］　刘永立，程富礼，景小博，等.儿童股骨干骨折切开复位钢板固定的优缺点［J］.中国继续医学教育，2016，8（19）：88-89.
［4］　许浩杰，孙祥水，汪飞，等.3种不同入路弹性髓内针治疗大龄儿童肱骨干骨折临床分析［J］.中华实用儿科临床杂志，2017，32（19）：1495-1499.
［5］　李辽波，张晓瑞，刘鹏.闭合弹性髓内钉微创技术在儿童股骨干骨折患者中的疗效观察及对术后软组织肿痛的影响研究［J］.临床医学研究与实践,2017，2（36）：64-65.
［6］　KOLMERT L,WULFF K.Epidemiology and treatment of distal femoral fractures in adults［J］.Acta Orthop Scand,1982,53(6):957-962.
［7］　郭志坚，陈剑锐.儿童股骨干骨折的手术治疗进展［J］.中华小儿外科杂志，2011，32（12）：939-942.
［8］　张立军.儿童股骨干骨折的规范化治疗［J］.中国骨与关节杂志，2015，4（10）：766-770.
［9］　高凤奇.弹性髓内针微创治疗小儿股骨干骨折疗效探讨［J］.系统医学，2017，2（5）：84-86.
［10］　丁启龙，李复琴.弹性髓内钉固定治疗小儿股骨骨折疗效观察［J］.现代医学与健康研究，2018，2（6）：24-26.
［11］　黄媛霞，陶金刚，赵红星，等.钛制弹性髓内钉治疗儿童长骨干骨折疗效观察［J］.新乡医学院学报，2017，34（2）：117-120.
［12］　俞永智，刘杰，郭士方，等.弹性髓内针治疗儿童尺桡骨骨折［J］.临床骨科杂志，2018，21（2）：236-237.
［13］　廖维，张志群，楼跃，等.弹性髓内钉在儿童陈旧性孟氏骨折治疗中的应用［J］.中华实用儿科临床杂志，2017，32（23）：1814-1816.

相似文献/References:

[1]元帅,史世峰,孙丽君,等.儿童行为问题研究现状[J].新乡医学院学报,,():000.
[2]于贵珍,郑素华,张文林,等.1120例儿童及青少年行为问题的调查研究[J].新乡医学院学报,1990,7(03):201.
[3]田明德.儿童转换型癔症25例报告[J].新乡医学院学报,1990,7(03):221.
[4]张华荣,卢振民,冯连铭,等.儿童急性中耳炎鼓膜穿孔的探讨[J].新乡医学院学报,1993,10(01):033.
[5]石太新,赵卫星,王礼周,等.小儿再生障碍性贫血骨髓细胞核仁形成区蛋白定量研究[J].新乡医学院学报,1995,12(02):147.
[6]席鸿钧,陈莹,李汉臣,等.经胃壁潜道食管胃粘膜腔内吻合治疗小儿食管狭窄[J].新乡医学院学报,1995,12(03):230.
[7]薛克修,陈金兰,支凌翔,等.儿童前臂缺血性挛缩的治疗[J].新乡医学院学报,1996,13(04):384.
[8]殷琪.儿童特发性高钙尿症12例[J].新乡医学院学报,1996,13(01):091.
[9]郑素华,付桂玲,张文林,等.行为异常儿童社交能力分析[J].新乡医学院学报,1997,14(04):363.
[10]贾东萱,石太新,贾汝贤,等.小儿恶性肿瘤及白血病226例回顾性分析[J].新乡医学院学报,1997,14(04):405.

更新日期/Last Update: 2019-03-05