Pandya Nirav K
Department of Pediatric Orthopaedics, University of California San Francisco Benioff Children's Hospitals, Oakland, CA.
J Pediatr Orthop. 2016 Jun;36 Suppl 1:S19-23. doi: 10.1097/BPO.0000000000000754.
Tibial shaft fractures are common injuries in the pediatric population, and can be treated conservatively the vast majority of the time. Yet, it is important to recognize that open and/or unstable tibial shaft fractures represent a different entity. Rigid intramedullary devices are generally contraindicated because of the skeletal immaturity of these patients, and external fixation is associated with a high complication rate. As a result, flexible nailing is being utilized with increasing frequency. It is essential for the clinician to understand the pearls and pitfalls associated with the utilization of these flexible nails; particularly in regards to their immediate use in the context of open fractures and the risk of compartment syndrome postoperatively after fixation.
胫骨干骨折是儿科人群中的常见损伤，绝大多数情况下可采用保守治疗。然而，必须认识到开放性和/或不稳定型胫骨干骨折是不同的情况。由于这些患者骨骼未成熟，刚性髓内装置通常是禁忌的，而外固定与高并发症发生率相关。因此，弹性髓内钉的使用频率越来越高。临床医生必须了解与使用这些弹性髓内钉相关的要点和陷阱；特别是在开放性骨折情况下立即使用以及固定后术后发生骨筋膜室综合征的风险方面。
