Sink Ernest L, Hedequist Daniel, Morgan Steven J, Hresko Timothy
Children's Hospital, Denver, CO 80218, USA.
J Pediatr Orthop. 2006 Mar-Apr;26(2):177-81. doi: 10.1097/01.bpo.0000218524.90620.34.
Twenty-seven patients underwent submuscular bridge plating for unstable pediatric femoral fractures with contraindications to fixation with flexible intramedullary nails. This report discusses the technique and results. A precontoured plate was tunneled proximally through a small distal incision in the subvastus plane to bridge the fracture. The plate was secured to the femur, with screws placed percutaneously proximal and distal to the fracture to reduce and stabilize the fracture. A retrospective review of radiographs and clinical follow-up was analyzed for postoperative alignment, any change in alignment or instrumentation failure, bony union, clinical exam, and complications. There were no intraoperative or postoperative complications. There has been no instrumentation failure or loss of reduction. Early callus was seen by 6 to 8 weeks and stable bony union by 12 weeks in all patients. Submuscular plating is a reasonable option for operative stabilization of comminuted and unstable pediatric femoral fractures.
27例患有不稳定型小儿股骨骨折且存在弹性髓内钉固定禁忌证的患儿接受了肌下桥接钢板固定术。本报告讨论了该技术及结果。一块预塑形钢板经股直肌平面的一个小切口向近端隧道化，以桥接骨折部位。将钢板固定于股骨，在骨折近端和远端经皮置入螺钉以复位和稳定骨折。对术后的X线片和临床随访进行回顾性分析，评估术后对线情况、对线或内固定失败的任何变化、骨愈合情况、临床检查及并发症。未发生术中或术后并发症。未出现内固定失败或复位丢失情况。所有患儿在6至8周时可见早期骨痂形成，12周时实现稳定的骨愈合。对于粉碎性和不稳定型小儿股骨骨折的手术稳定，肌下钢板固定是一种合理的选择。
