Jalan Divesh, Chandra Rajesh, Sharma V-K
All India Institute of Medical Sciences, New Delhi 110029, India.
Chin J Traumatol. 2013;16(2):77-83.
Fractures of the femur are the most incapacitating fractures. For children aged 6-14 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and casting is no longer recommended. We report our experience in titanium elastic nailing for treatment of paediatric femoral diaphyseal fractures.
Thirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were stabilized with titanium elastic nails. Patients were followed up clinically and radiologically for a minimum period of 1 year. The final results were evaluated using Flynn's criteria. Technical difficulties and complications associated with the procedure were also analysed.
Overall results were excellent in 20 cases and satisfactory in 10 cases. No patient had poor result. The average hospital stay was 9 days. All the fractures healed with an average time to union of 6.86 weeks. The most common complication encountered was soft tissue irritation at the nail entry site seen in 6 cases. Clinically, lengthening was noticed in 4 cases, while no patient had shortening. Malalignment was seen in only 6 cases. Perioperative difficulties encountered were failure of closed reduction seen in 6 cases and corkscrewing of nails in one case.
Titanium elastic nails are a relatively easy to use, minimally invasive, physeal-protective implant system with high rate of good and excellent outcomes in children aged 6-16 years. Technical pitfalls can be eliminated by adhering to the basic principles.
股骨骨折是最使人丧失活动能力的骨折。对于6至14岁的儿童，关于首选治疗方法尚无明确共识。传统的牵引和石膏固定治疗方法已不再被推荐。我们报告我们使用钛弹性髓内钉治疗儿童股骨干骨折的经验。
对30例年龄在6至16岁的股骨干移位骨折患者采用钛弹性髓内钉进行固定。对患者进行临床和影像学随访至少1年。使用弗林标准评估最终结果。还分析了与该手术相关的技术难点和并发症。
总体结果为20例优，10例良。无患者结果差。平均住院时间为9天。所有骨折均愈合，平均愈合时间为6.86周。最常见的并发症是6例出现的钉道处软组织刺激。临床上，4例出现肢体延长，无患者出现肢体缩短。仅6例出现对线不良。围手术期遇到的困难包括6例闭合复位失败和1例髓内钉钉入时出现螺旋现象。
钛弹性髓内钉是一种相对易于使用、微创、保护骨骺的植入系统，在6至16岁儿童中具有较高的优良率。遵循基本原则可消除技术上的缺陷。
