Rollo Giuseppe, Guida Pasquale, Bisaccia Michele, Pichierri Paolo, Filipponi Marco, Lanzetti Riccardo Maria, Caraffa Auro, Stasi Alessandro, Russi Valentina, Lupariello Domenico, Meccariello Luigi
Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy.
Department of Orthopedics and Traumatology, Pediatric Hospital Santobono Pausilipon, Naples, Italy.
Eur J Orthop Surg Traumatol. 2018 Oct;28(7):1421-1428. doi: 10.1007/s00590-018-2201-3. Epub 2018 Apr 20.
Over the last 20 years, the incidence of pediatric diaphyseal femoral fractures was increased, due to changes in the children's daily activities. The healing times are different according to the chosen treatment and to other factors such as age, type of fracture, involvement of the soft tissues, and concomitance with other injuries.
From 2000 to 2015, 38 pediatric patients with diaphyseal femoral fractures were surgically treated and enrolled in the study. The average age of the patients was between 3 and 15 years. Twenty-two patients were treated with endomedullary titanium nails (TEN) and the other 16 with external axial fixators. Comparing the two groups, radiographic images were taken to assess the fracture reduction and consolidation.
The average follow-up was 14 months. The average time needed to remove the TEN nails was 5 months; while 2.5 months was the time to remove the external fixator. At the final follow-up, there were no differences between two groups in term of significant rotation defects, angulation, growth, and/or nonunion.
This study showed that TENS and external fixation have similar results in term of fracture healing and complication, even if patients treated with TENS are more satisfied.
在过去20年中，由于儿童日常活动的变化，小儿股骨干骨折的发病率有所增加。根据所选择的治疗方法以及其他因素（如年龄、骨折类型、软组织受累情况和是否合并其他损伤），愈合时间各不相同。
2000年至2015年，38例小儿股骨干骨折患者接受了手术治疗并纳入本研究。患者的平均年龄在3至15岁之间。22例患者采用髓内钛钉（TEN）治疗，另外16例采用外固定架治疗。比较两组患者，通过拍摄X线片评估骨折复位和愈合情况。
平均随访时间为14个月。取出TEN钉的平均时间为5个月；而取出外固定架的时间为2.5个月。在最后一次随访时，两组在明显旋转畸形、成角、生长和/或骨不连方面没有差异。
本研究表明，就骨折愈合和并发症而言，髓内钛钉和外固定治疗效果相似，尽管接受髓内钛钉治疗的患者满意度更高。
