Barlas Khurram, Beg Humayun
Department of Orthopaedics, Victoria Hospital, Blackpool, United Kingdom.
Acta Orthop Belg. 2006 Apr;72(2):159-63.
Treatment outcomes were compared in two groups of children with femoral diaphyseal fractures which were treated with external fixation (20 fractures) or flexible intramedullary nailing (20 fractures). These 40 children were between 5.4 to 14.1 years of age. The duration of the operation averaged 52 minutes for the external fixator compared with 70 minutes for the flexible nail group. The time taken to gain full weight bearing, full range of movements and return to school was shorter in the flexible intramedullary nail group. There was a higher complication rate in the external fixator group than in the flexible nail group. At final review, three patients in the external fixator group had pain, two had leg-length discrepancy of up to 1 cm, and four had malalignment of 5 degrees -10 degrees. In the nailing group, there were no leg-length discrepancies or malalignments. We recommend the use of flexible intramedullary nailing for fractures of the femoral shaft in children which require surgery, and reserve external fixation for open or severely comminuted fractures.
对两组股骨干骨折儿童的治疗结果进行了比较，一组采用外固定治疗（20例骨折），另一组采用弹性髓内钉治疗（20例骨折）。这40名儿童年龄在5.4至14.1岁之间。外固定器组手术平均时长为52分钟，而弹性髓内钉组为70分钟。弹性髓内钉组在实现完全负重、恢复全关节活动范围以及返校时间方面所需时间更短。外固定器组的并发症发生率高于弹性髓内钉组。在最终复查时，外固定器组有3例患者疼痛，2例患者腿长相差达1厘米，4例患者有5度至10度的畸形。在髓内钉组，没有腿长差异或畸形情况。我们建议，对于需要手术治疗的儿童股骨干骨折，采用弹性髓内钉治疗，而开放性或严重粉碎性骨折则采用外固定治疗。
