Khazzam Michael, Tassone Channing, Liu Xue C, Lyon Roger, Freeto Brian, Schwab Jeffery, Thometz John
Department of Orthopaedics, University of Missouri, Columbia, Missouri, USA.
Am J Orthop (Belle Mead NJ). 2009 Mar;38(3):E49-55.
We evaluated use of flexible intramedullary nails in the surgical treatment of femoral shaft fractures in 135 children (138 fractures). Mean age was 9.7 years (range, 2-17 years). Mean follow-up was 15.6 months (range, 6.6-53.5 months). Seventy-two patients were treated with stainless-steel (Ender) nails and 66 with titanium elastic nails. There were 73 midshaft fractures, 48 proximal-third fractures, and 17 distal-third fractures. Fracture patterns were transverse (66), oblique (42), spiral (24), and comminuted (6). There were 16 complications--3 refractures, 2 delayed unions, 3 varus or valgus malalignments, 5 nail-tip irritations, 2 broken interlocking screws (found incidentally on radiographs), and 1 asymptomatic proximal nail migration--for a complication rate of 11.7%. These results demonstrate that use of flexible intramedullary nails in the treatment of femoral shaft fractures in children is successful regardless of patient age, fracture location, or fracture pattern.
我们评估了弹性髓内钉在135例儿童（138处骨折）股骨干骨折手术治疗中的应用情况。平均年龄为9.7岁（范围2至17岁）。平均随访时间为15.6个月（范围6.6至53.5个月）。72例患者采用不锈钢（Ender）钉治疗，66例采用钛弹性钉治疗。有73处中段骨折、48处近端三分之一骨折和17处远端三分之一骨折。骨折类型为横形（66处）、斜形（42处）、螺旋形（24处）和粉碎性（6处）。共有16例并发症——3例再骨折、2例延迟愈合、3例内翻或外翻畸形、5例钉尖刺激、2例锁定螺钉断裂（在X线片上偶然发现）和1例近端钉无症状移位——并发症发生率为11.7%。这些结果表明，无论患者年龄、骨折部位或骨折类型如何，弹性髓内钉治疗儿童股骨干骨折均取得成功。
