Weiss A P, Schenck R C, Sponseller P D, Thompson J D
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Pediatr Orthop. 1992 Jan;12(1):25-8.
The incidence and contributing factors associated with post-casting peroneal nerve palsy were examined in a series of 110 consecutive pediatric femoral shaft fractures treated with early hip spica cast application. Four patients with peroneal nerve palsy were identified. All four had 90 degrees/90 degrees casts placed and underwent cast wedging for alignment. All palsies resolved with immediate cast removal. Other treatment options for certain femur fractures with significant initial shortening should be considered. We advise pre- and post-cast neurologic examination and avoidance of forceful distraction. Fracture manipulation, through wedging, should be delayed.
在一系列110例连续接受早期髋人字石膏固定治疗的小儿股骨干骨折中，对石膏固定后腓总神经麻痹的发生率及相关因素进行了研究。确定了4例腓总神经麻痹患者。所有4例均采用90度/90度石膏固定，并进行了石膏楔形矫正以调整对线。所有麻痹在立即拆除石膏后均得到缓解。对于某些初始短缩明显的股骨骨折，应考虑其他治疗选择。我们建议在石膏固定前后进行神经学检查，并避免强力牵引。通过楔形矫正进行骨折手法复位应延迟进行。
