Kang S-N, Mangwani J, Ramachandran M, Paterson J M H, Barry M
Department of Trauma and Orthopaedics, Barts and The London NHS Trust, Royal London Hospital, Whitechapel Road, London E1 1BB, UK.
J Bone Joint Surg Br. 2011 Feb;93(2):262-5. doi: 10.1302/0301-620X.93B2.24882.
We present the results of 90 consecutive children with displaced fractures of the forearm treated by elastic stable intramedullary nailing with a mean follow-up of 6.6 months (2.0 to 17.6). Eight (9%) had open fractures and 77 (86%) had sustained a fracture of both bones. The operations were performed by orthopaedic trainees in 78 patients (86%). All fractures healed at a mean of 2.9 months (1.1 to 8.7). There was one case of delayed union of an ulnar fracture. An excellent or good functional outcome was achieved in 76 patients (84%). There was no statistical difference detected when the grade of operating surgeon, age of the patient and the diaphyseal level of the fracture were correlated with the outcome. A limited open reduction was required in 40 fractures (44%). Complications included seven cases of problematic wounds, two transient palsies of the superficial radial nerve and one case each of malunion and a post-operative compartment syndrome. At final follow-up, all children were pain-free and without limitation of sport and play activities. Our findings indicate that the functional outcome following paediatric fractures of the forearm treated by elastic stable intramedullary nailing is good, without the need for anatomical restoration of the radial bow.
我们报告了90例连续的前臂移位骨折儿童患者采用弹性稳定髓内钉治疗的结果，平均随访时间为6.6个月（2.0至17.6个月）。其中8例（9%）为开放性骨折，77例（86%）为双骨折。78例患者（86%）的手术由骨科住院医师完成。所有骨折平均在2.9个月（1.1至8.7个月）愈合。有1例尺骨骨折延迟愈合。76例患者（84%）获得了优良的功能结果。手术医生级别、患者年龄和骨折骨干水平与结果之间未检测到统计学差异。40例骨折（44%）需要有限切开复位。并发症包括7例伤口问题、2例桡浅神经短暂性麻痹、1例畸形愈合和1例术后骨筋膜室综合征。在末次随访时，所有儿童均无疼痛，运动和玩耍活动不受限。我们的研究结果表明，采用弹性稳定髓内钉治疗儿童前臂骨折后的功能结果良好，无需对桡骨弓进行解剖复位。
