Pombo Mathew William, Shilt Jeffrey S
Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157-1034, USA.
J Pediatr Orthop. 2006 May-Jun;26(3):364-70. doi: 10.1097/01.bpo.0000203005.50906.41.
Titanium elastic nailing (TEN) has become more common in the treatment of pediatric femur fractures in many European centers and in North America over the past several years. Prior studies have shown that the use of TEN for midshaft femur fractures results in excellent outcomes with an earlier return to activity, earlier mobilization, and a shortened hospital stay. However, subtrochanteric femur fractures continue to remain a difficult subset of fractures to care for, with loss of reduction and nonunion being significant complications. Studies have differed regarding the definition of pediatric subtrochanteric femur fractures. The purpose of this study is to establish a reproducible method of defining pediatric subtrochanteric fractures and then apply that definition in a retrospective review of 13 patients who sustained subtrochanteric femur fractures treated with TEN at North Carolina Baptist Hospital using a modified technique that allows for improved fracture stability.
Charts and radiographs were retrospectively reviewed for all pediatric patients sustaining subtrochanteric femur fractures treated with TEN from the period of 2000 to 2004 at Wake Forest University. The TEN outcome measures scale was applied to determine their results.
TEN allowed rapid mobilization with excellent or satisfactory clinical and radiographic results in all patients.
Results suggest that the use of TEN for subtrochanteric femur fractures is a safe and effective method of fixation that benefits patients through early mobilization, shorter hospital stays, and fewer complications.
By applying the definition of subtrochanteric femur fractures described by the authors, results of future studies can be objectively compared and classified. TEN is a safe and effective alternative for treating most pediatric subtrochanteric fractures by decreasing the morbidity that occurs with other treatment modalities.
在过去几年中，钛弹性髓内钉（TEN）在许多欧洲中心和北美地区治疗儿童股骨骨折方面变得越来越普遍。先前的研究表明，使用TEN治疗股骨干骨折可取得优异的效果，能使患者更早恢复活动、更早进行活动，缩短住院时间。然而，股骨转子下骨折仍然是一类难以处理的骨折，复位丢失和骨不连是严重的并发症。关于儿童股骨转子下骨折的定义，各项研究存在差异。本研究的目的是建立一种可重复的儿童股骨转子下骨折定义方法，然后将该定义应用于对13例在北卡罗来纳浸信会医院接受TEN治疗的股骨转子下骨折患者的回顾性研究中，采用一种改良技术以提高骨折稳定性。
对2000年至2004年期间在维克森林大学接受TEN治疗的所有儿童股骨转子下骨折患者的病历和X线片进行回顾性研究。应用TEN疗效评估量表来确定结果。
TEN使所有患者都能迅速活动，临床和影像学结果优异或令人满意。
结果表明，使用TEN治疗股骨转子下骨折是一种安全有效的固定方法，通过早期活动、缩短住院时间和减少并发症使患者受益。
通过应用作者描述的股骨转子下骨折定义，未来研究的结果可以进行客观比较和分类。TEN是治疗大多数儿童股骨转子下骨折的一种安全有效的替代方法，可降低其他治疗方式所带来的发病率。
