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儿童股骨髁上骨折:移位骨折的闭合复位与经皮穿针固定

Supracondylar fractures of the femur in children: closed reduction and percutaneous pinning of displaced fractures.

作者信息

Butcher Christopher C, Hoffman Eduard Bernard

机构信息

Department of Orthopaedic Surgery at Red Cross Children's Hospital and Maitland Cottage Hospital, University of Cape Town, Cape Town, South Africa.

出版信息

J Pediatr Orthop. 2005 Mar-Apr;25(2):145-8. doi: 10.1097/01.bpo.0000149860.50400.92.

Abstract

The authors reviewed nine children with 10 displaced supracondylar femoral fractures that were treated by closed reduction and percutaneous pinning. The average age of the patients was 8.3 years (range 5-13). After removal of the pins and plaster at 5 weeks, full range of movement was regained within 3 weeks. At late follow-up (average 7.4 years [range 4-10]), seven of the eight patients reviewed (nine fractures) had a satisfactory result. One patient had a valgus deformity of 6 degrees. There was no growth plate arrest and no leg length discrepancy. Intra-articular pin placement was avoided, considering the different synovial attachments on the medial and lateral sides. One patient developed a common peroneal nerve palsy, and therefore a cadaver study was performed to determine whether movement of the knee after pin placement affected the nerve. Although the lateral pin did tether the iliotibial band, the common peroneal nerve was not affected.

摘要

作者回顾了9例患有10处移位型股骨髁上骨折的儿童病例,这些病例均采用闭合复位和经皮穿针固定治疗。患者的平均年龄为8.3岁(范围5 - 13岁)。在5周时取出钢针和石膏后,3周内恢复了全范围活动。在后期随访(平均7.4年[范围4 - 10年])时,接受复查的8例患者(9处骨折)中有7例结果满意。1例患者有6度外翻畸形。没有生长板阻滞,也没有腿长差异。考虑到内外侧不同的滑膜附着情况,避免了关节内穿针。1例患者出现腓总神经麻痹,因此进行了尸体研究以确定穿针后膝关节活动是否会影响该神经。尽管外侧钢针确实束缚了髂胫束,但腓总神经未受影响。

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