Hammad Akram
Orthopaedic Department, Mansoura University Hospital, Mansoura 35516, Egypt.
Acta Orthop Belg. 2008 Oct;74(5):630-5.
Different methods of internal fixation are used in the treatment of femoral shaft fractures. Results of locked plate fixation in adults have been encouraging. A locking plate construct with a standard broad Dynamic Compression Plate (DCP) and 4.5 mm nuts was used in the treatment of femoral shaft fractures in 15 skeletally immature patients. There were 12 boys and three girls. The mean age was 9.4 years at time of injury. Three fractures were open. All fracture healed in an average time of 8 weeks. The follow-up period ranged from 6 to 30 months (mean 18 months). Screw failure in form of bending or breakage occurred in two patients, without clinical consequences. Fatigue fracture of the two screws in the proximal fragment occurred 15 weeks after fixation in another patient, which eventually healed with a 15 degrees varus angulation. There was an average femoral lengthening of 2.3 mm in six patients and 2 mm of tibial lengthening in four patients. All patients returned to their pre fracture level of activity. The locking plate construct used in this study appeared as a reliable method for the treatment of femoral shaft fractures in skeletally immature patients.
股骨干骨折的治疗采用了不同的内固定方法。成人锁定钢板固定的结果令人鼓舞。一种由标准宽动力加压钢板（DCP）和4.5毫米螺母组成的锁定钢板结构被用于治疗15例骨骼未成熟患者的股骨干骨折。其中有12名男孩和3名女孩。受伤时的平均年龄为9.4岁。有3处骨折为开放性骨折。所有骨折平均在8周内愈合。随访期为6至30个月（平均18个月）。两名患者出现螺钉弯曲或断裂形式的螺钉失效，但未产生临床后果。另一名患者在固定15周后近端骨折块中的两枚螺钉发生疲劳骨折，最终愈合时出现15度内翻成角。6例患者平均股骨延长2.3毫米，4例患者胫骨延长2毫米。所有患者均恢复到骨折前的活动水平。本研究中使用的锁定钢板结构似乎是治疗骨骼未成熟患者股骨干骨折的可靠方法。
