Biber R, Stedtfeld H-W, Bail H J
Department of Trauma and Orthopaedic Surgery, Klinikum Nürnberg Sued, Breslauer Strasse 201, 90471 Nuernberg, Germany.
Orthop Traumatol Surg Res. 2014 Oct;100(6):699-702. doi: 10.1016/j.otsr.2014.05.002. Epub 2014 Jun 23.
Recommendations for distal femoral fracture treatment in children with neuromuscular disease are various, including conservative, plating, nailing, and ESIN. All methods have disadvantages. Retrograde femoral intramedullary nailing using a statically interlocked Targon PH nail was performed in three cases. A right nail was used for a right femur (and vice versa). A short nail was used for supracondylar fractures, a long nail for distal femoral shaft fractures. Closed reduction was performed in all cases. Despite osteopenia, small bone dimensions and muscle dystrophy, no intraoperative or postoperative complications occurred. All cases achieved primary stability, allowing immediate rehabilitation. Bone healing occurred uneventfully within four months. No deterioration of functional status or range of motion was seen. There were no peri-implant fractures or hardware removal need over a two-year-period. Retrograde femoral nailing with the Targon PH nail seems to be a reasonable treatment concept for these rare and demanding cases.
IV.
对于患有神经肌肉疾病的儿童股骨远端骨折的治疗建议多种多样，包括保守治疗、钢板固定、髓内钉固定和弹性髓内钉固定。所有方法都有缺点。对三例患者采用静态交锁的Targon PH髓内钉进行逆行股骨髓内钉固定术。右股骨使用右髓内钉（反之亦然）。髁上骨折使用短髓内钉，股骨干远端骨折使用长髓内钉。所有病例均采用闭合复位。尽管存在骨质减少、骨骼尺寸小和肌肉萎缩，但术中及术后均未发生并发症。所有病例均实现了初始稳定性，允许立即进行康复治疗。骨折在四个月内顺利愈合。未观察到功能状态或活动范围恶化。在两年期间内未发生植入物周围骨折或需要取出内固定装置的情况。对于这些罕见且棘手的病例，使用Targon PH髓内钉进行逆行股骨髓内钉固定似乎是一种合理的治疗方案。
IV级。
