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小儿股骨干骨折中髓内克氏针固定与钛弹性髓内钉固定的对比研究

Comparative Study Using Intramedullary K-wire Fixation Over Titanium Elastic Nail in Paediatric Shaft Femur Fractures.

作者信息

Kumar Sanjiv, Anand Tushar, Singh Sudhir

机构信息

Assistant Professor, Department of Orthopaedics, Era,s Lucknow Medical College & Hospital , Lucknow, UP, India .

Junior Resident, Department of Orthopaedics, Era,s Lucknow Medical College & Hospital , Lucknow, UP, India .

出版信息

J Clin Diagn Res. 2014 Nov;8(11):LC08-10. doi: 10.7860/JCDR/2014/9687.5119. Epub 2014 Nov 20.

Abstract

BACKGROUND

Fracture shaft femur is common paediatric trauma leading to significant morbidity. Conservative treatments available are associated with prolonged periods of immobilization. Use of flexible intramedullary implant allows early rehabilitation in diaphyseal fractures of femur in children.

AIM

The aim of the present study is to compare fixation of diaphyseal femur fracture by titanium elastic nail and intramedullary K-wires in children.

SETTING AND DESIGN

Prospective randomized study in a tertiary care hospital.

MATERIAL AND METHODS

Fifty-two children between 6 years and 14 years of age with femoral shaft fracture were assigned either in Group I or Group II based on computer generated random numbers. In Group I closed percutaneous intramedullary K- wire fixation and in Group II closed percutaneous intramedullary titanium elastic nail was used to fix the fractures. Partial weight bearing was allowed after 6 weeks of surgery and full weight bearing at clinico-radiological union.

RESULTS

Average time of radiological union was 6 to 10 weeks in both groups. In both the groups two cases had entry site irritation which resolved with early implant removal. One case in both the groups had unacceptable mal-alignment. Both the groups had few cases of limb-length discrepancy, which was in acceptable limit, except two cases of TENS. There was no statistically significant difference between the results of both the groups. But, using K-wires significantly reduced the cost of treatment.

CONCLUSION

Most of such fractures in our society are neglected because of high cost of treatment. Providing a cheaper alternative in form of K-wires may be beneficial for the patients from low socio-economic status.

摘要

背景

股骨干骨折是常见的儿科创伤,会导致严重的发病率。现有的保守治疗方法与长时间固定有关。使用弹性髓内植入物可使儿童股骨干骨折早期康复。

目的

本研究的目的是比较钛弹性钉和髓内克氏针治疗儿童股骨干骨折的固定效果。

设置与设计

在一家三级护理医院进行的前瞻性随机研究。

材料与方法

52例6至14岁股骨干骨折患儿根据计算机生成的随机数分为I组或II组。I组采用闭合经皮髓内克氏针固定,II组采用闭合经皮髓内钛弹性钉固定骨折。术后6周允许部分负重,临床影像学愈合后完全负重。

结果

两组的平均放射学愈合时间均为6至10周。两组均有2例出现入路部位刺激,早期取出植入物后症状缓解。两组各有1例出现不可接受的畸形排列。两组均有少数肢体长度差异病例,除2例钛弹性钉固定病例外,均在可接受范围内。两组结果之间无统计学显著差异。但是,使用克氏针显著降低了治疗成本。

结论

由于治疗费用高昂,社会上大多数此类骨折都被忽视。以克氏针形式提供更便宜的替代方案可能对社会经济地位较低的患者有益。

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