Buechsenschuetz Karl E, Mehlman Charles T, Shaw Kevin J, Crawford Alvin H, Immerman Elisa B
Big Sky Orthopaedic Specialists, Missoula, Montana, USA.
J Trauma. 2002 Nov;53(5):914-21. doi: 10.1097/00005373-200211000-00017.
Treatment of pediatric femoral fractures by 90/90 traction and spica casting (TXN/CST) has begun to be replaced by elastic stable intramedullary nailing (ESIN). The purpose of our study was to perform a cost analysis of TXN/CST versus ESIN in addition to comparing clinical/functional parameters.
We reviewed all children admitted with femoral shaft fractures between January 1995 and April 1998. Overall cost and clinical/radiographic outcome measures were analyzed, and 60% of patients' parents completed a follow-up telephone interview. Sixty-eight patients representing 71 femoral shaft fractures that had complete data and 1-year follow-up were included.
No difference existed between the two groups for standard clinical/functional criteria. ESIN was associated with a lower overall cost than TXN/CST. ESIN also resulted in better scar acceptance, and higher overall parent satisfaction.
Less cost and comparable clinical outcome make ESIN a better option than traditional TXN/CST for femoral fracture care in the skeletally immature patient.
90/90牵引及髋人字石膏固定（TXN/CST）治疗小儿股骨干骨折的方法已开始被弹性稳定髓内钉固定（ESIN）所取代。我们研究的目的是除比较临床/功能参数外，对TXN/CST与ESIN进行成本分析。
我们回顾了1995年1月至1998年4月间所有因股骨干骨折入院的儿童。分析了总体成本及临床/影像学结果指标，60%患者的家长完成了随访电话访谈。纳入了代表71例股骨干骨折且有完整数据及1年随访的68例患者。
两组在标准临床/功能标准方面无差异。ESIN的总体成本低于TXN/CST。ESIN还使瘢痕接受度更高，家长总体满意度更高。
成本更低且临床结果相当，使得ESIN对于骨骼未成熟患者的股骨干骨折治疗而言是比传统TXN/CST更好的选择。
