Hedequist Daniel, Bishop Julius, Hresko Timothy
Department of Orthopedics, Children's Hospital/Harvard Medical School, Boston, MA 02115, USA.
J Pediatr Orthop. 2008 Jan-Feb;28(1):6-9. doi: 10.1097/bpo.0b013e31815ff301.
The use of locking plates for pediatric femur fractures has not been studied. Locking plate applications for fractures associated with comminution, osteopenia, or minimal bone available for purchase have been well studied in the adult trauma population.
We conducted a retrospective review of children at our institution treated with a locking plate for a femur fracture. We identified 32 patients treated at an average age of 11 years (6-15 years of age). Locking plates were chosen for comminution in 13 patients, nonmalignant pathologic fracture in 9 patients, fracture location in 7 patients, and osteopenia in 3 patients. All patients were treated with a locking plate and followed up until definitive radiologic union.
There were no intraoperative complications related to this technology. All patients were healed with near-anatomic alignment with the exception of 1 patient who had valgus malalignment of 12 degrees, which was of no clinical concern and required no intervention. Seven patients had the plates removed with no noted complications.
Locking plates are a safe and effective treatment for children and adolescents with femur fractures that may not be amenable to other current means of stabilization.
锁定钢板在儿童股骨骨折中的应用尚未得到研究。锁定钢板在成人创伤患者中用于治疗伴有粉碎性骨折、骨质减少或可供固定的骨量极少的骨折已得到充分研究。
我们对在我院接受锁定钢板治疗股骨骨折的儿童进行了回顾性研究。我们确定了32例患者，平均年龄为11岁（6至15岁）。选择锁定钢板治疗的患者中，13例为粉碎性骨折，9例为非恶性病理性骨折，7例为骨折部位特殊，3例为骨质减少。所有患者均接受锁定钢板治疗，并随访至影像学确定骨折愈合。
术中未出现与该技术相关的并发症。除1例患者存在12度外翻畸形外，所有患者均获得了接近解剖复位的愈合，该外翻畸形无临床意义，无需干预。7例患者取出钢板，未出现明显并发症。
对于儿童和青少年股骨骨折，锁定钢板是一种安全有效的治疗方法，这些骨折可能不适用于目前其他的固定方法。
