Yang Ming-Xing, Chi Yong-Long, Wang Chun, Sun Liao-Jun, Zhang Jing-Dong
Department of Orthopaedics, the Second Hospital Affiliated to Wenzhou Medical College, Zhejiang, China.
Zhongguo Gu Shang. 2012 Feb;25(2):116-9.
To investigate curative effects of elastic stable intramedullary nails in the treatment of stable and unstable fractures of femoral shaft in children and to guide its clinical application.
From January 2008 to October 2010,44 children with femoral shaft fractures were treated,including 24 boys and 20 girls,ranging in age from 5 to 12 years, with an average of 7.4 years. Based on the fractures stable or not, the patients were divided into stable fractures group(group S) and unstable fractures group (group U). All the children received the same operation to fix broken femoral with elastic stable intramedullary nails and some children received traction or small splint protection after operation when reduction and fixation were considered unsatisfied or his/her weight beyond 30 kg. During the followed-up, the healing time, irritation of the soft tissue (ache, cyst, t al), malunion (angulation above 5 degree in X-ray), limb shortening or lengthening and excellent and good rate were observed.
All the patients were followed up,and the duration ranged from 5 to 19 months, with an average of 13 months. All the fractures were healed at the latest follow-up. The average healing time was 10.2 weeks (ranges, 8 to 14 weeks). The incidence rate of malunion was 23.8% in group U and the average angulation was 9 degree (6 to 12 degree), which was higher than those of patients in the group S (0%). The average healing time, limb shortening or lengthening, irritation of the soft tissue and the excellent and good rate between two groups had no significance differences, which were (10.6 +/- 1.3) vs. (9.9 +/- 1.2) weeks, 0 vs. 3 cases, 3 vs. 1 case and 2 vs. 4 cases respectively. In the group U, among 5 patients had malunion, 4 patients were not treated with traction or small splint protection,and the incidence was higher than those who were given traction or small splint protection.
Both the stable and unstable femoral shaft fractures in children treated with elastic stable intramedullary nails can receive well short-term curative effects. If given certain postoperative protection like as traction or small splint, the malunion incidence can be reduced.
探讨弹性稳定髓内钉治疗儿童股骨干稳定及不稳定骨折的疗效，以指导其临床应用。
2008年1月至2010年10月，收治44例股骨干骨折患儿，其中男24例，女20例，年龄5～12岁，平均7.4岁。根据骨折是否稳定将患儿分为稳定骨折组（S组）和不稳定骨折组（U组）。所有患儿均采用弹性稳定髓内钉固定股骨干骨折，部分患儿在复位固定不满意或体重超过30 kg时，术后给予牵引或小夹板保护。随访观察愈合时间、软组织刺激情况（疼痛、囊肿、压痛等）、畸形愈合（X线示成角大于5度）、肢体短缩或延长情况及优良率。
所有患儿均获随访，随访时间5～19个月，平均13个月。所有骨折均在末次随访时愈合。平均愈合时间为10.2周（8～14周）。U组畸形愈合发生率为23.8%，平均成角9度（6～12度），高于S组（0%）。两组平均愈合时间、肢体短缩或延长、软组织刺激情况及优良率比较，差异均无统计学意义，分别为（10.6±1.3）周对（9.9±1.2）周、0例对3例、3例对l例、2例对4例。U组5例畸形愈合患儿中，4例未给予牵引或小夹板保护，其发生率高于给予牵引或小夹板保护者。
弹性稳定髓内钉治疗儿童股骨干稳定及不稳定骨折均有良好的近期疗效。术后给予牵引或小夹板等适当保护，可降低畸形愈合发生率。
