Rathjen Karl E, Riccio Anthony I, De La Garza David
Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA.
J Pediatr Orthop. 2007 Jun;27(4):432-41. doi: 10.1097/01.bpb.0000271322.48987.46.
To assess the role of stainless steel flexible intramedullary fixation in unstable pediatric femur fractures, we compared a group of 41 stable (transverse or oblique) fractures with a group of 40 unstable (spiral and/or comminuted) fractures treated with stainless steel (Ender) nails placed through a single lateral insertion. The fractures were followed up until clinical and radiographic union was evident with an average follow-up period of 13 months. All fractures were healed at an average of 1.4 months. No infections or refractures occurred. Although minor radiographic angular deformities and shortening were present in both groups, no patient had a clinically detectable angular deformity. Two patients with stable fracture patterns had 10 to 20 degrees of asymmetry in foot progression angles, and 1 patient with an unstable fracture pattern (Winquist grade IV comminution) had a 3-cm limb length difference at final follow-up. Stainless steel flexible intramedullary fixation is effective for unstable pediatric femur fractures if cortical abutment is present.
为评估不锈钢弹性髓内固定在小儿不稳定型股骨骨折中的作用，我们将一组41例稳定型（横行或斜行）骨折与一组40例不稳定型（螺旋形和/或粉碎性）骨折进行了比较，两组均采用经单一外侧入路置入不锈钢（恩德勒）钉治疗。对骨折进行随访，直至临床和影像学显示愈合，平均随访期为13个月。所有骨折平均在1.4个月时愈合。未发生感染或再骨折。虽然两组均存在轻微的影像学角度畸形和短缩，但没有患者存在临床可检测到的角度畸形。两名稳定骨折类型的患者足部前进角度不对称10至20度，一名不稳定骨折类型（温奎斯特IV级粉碎）的患者在最终随访时肢体长度相差3 cm。如果存在皮质对接，不锈钢弹性髓内固定对小儿不稳定型股骨骨折有效。
