Vidyadhara S, Rao S K
Department of Orthopaedics, Kasturba Medical College, Manipal 576104, Karnataka, India.
Singapore Med J. 2006 Sep;47(9):817-9.
An 11-year-old girl with type IIIA open fracture of the femoral shaft and 4.5 cm bone loss, was treated by global reconstruction using a reamed, interlocking, intramedullary titanium nail, following meticulous primary debridement with pulsed lavage irrigation. The nail entry was carefully chosen at the lateral transtrochanteric point in order to avoid any vascular damage to the head of femur. The osteophilic nature of the titanium nail, in addition to the thick periosteum of the paediatric bone, helped satisfactory union despite a hostile environment. The child had 0-90 degrees flexion of the knee without any extensor lag at the last follow-up. To our knowledge, this is the first case described in the literature that proves the efficacy of nailing for such a fracture.
一名11岁女童，股骨干开放性ⅢA型骨折，骨缺损4.5厘米，在进行细致的一期清创和脉冲冲洗后，使用扩髓、带锁髓内钛钉进行整体重建治疗。钉入点精心选择在外侧转子下部位，以避免对股骨头造成任何血管损伤。钛钉的亲骨性，加上儿童骨骼较厚的骨膜，尽管环境不利，但仍有助于实现满意的愈合。在最后一次随访时，患儿膝关节可从0度屈曲到90度，无伸肌滞后。据我们所知，这是文献中描述的首例证明此类骨折使用髓内钉治疗有效性的病例。
