Xu Xuepeng, Lu Xiaobo, Luo Leiming, Zhang Xihai, Wang Yuanhui
Department of Bone and Joint Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China.
Department of Bone and Joint Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Oct 15;31(10):1184-1189. doi: 10.7507/1002-1892.201704122.
To compare the effectiveness of titanium elastic nail (TEN) and locking compression plate fixation in treating femoral subtrochanteric fracture in older children.
Between April 2015 and September 2016, 35 older children (aged 7-13 years) with femoral subtrochanteric fractures were treated, the clinical data were retrospectively reviewed. TEN fixation was used in 19 cases (group A) and locking compression plate fixation in 16 cases (group B). There was no significant difference in age, gender, sides, fracture causes, type of fracture, and time from injury to operation between 2 groups ( >0.05). The fluoroscopy times, operation time, intraoperative blood loss, fracture healing time were recorded and compared between 2 groups. The limb function was evaluated according to the Sanders scores and Flynn . outcome score.
All the patients were followed up 6-24 months (mean, 11.46 months). The operation time, intraoperative blood loss, and fracture healing time of group A were significantly less than those of group B, but the fluoroscopy times of group A was significantly more than that of group B ( <0.05). All the fractures were healed, no breakage of screw, infection of deep tissue, nerve injury, osteonecrosis of the femoral head, or other complication occurred. At last follow-up, according to the Sanders scores, the results were excellent in 14 cases, good in 4 cases, and fair in 1 case in group A with an excellent and good rate of 94.74%; the results were excellent in 12 cases, good in 3 cases, and fair in 1 case in group B with an excellent and good rate of 93.75%; showing no significant difference between 2 groups ( =0.400, =0.980). According to the Flynn . outcome score, the results were excellent in 13 cases, good in 5 cases, and fair in 1 case in group A with an excellent and good rate of 94.74%; the results were excellent in 11 cases, good in 3 cases, and fair in 2 cases in group B with an excellent and good rate of 87.50%; showing no significant difference between 2 groups ( =0.748, =0.688).
Both TEN and locking compression plate have satisfactory outcomes for treating pediatric femoral subtrochanteric fractures. TEN method has minimally trauma, security, and faster fracture healing when compared with locking compression plate.
比较钛弹性髓内钉（TEN）与锁定加压钢板固定治疗大龄儿童股骨转子下骨折的疗效。
回顾性分析2015年4月至2016年9月收治的35例7~13岁股骨转子下骨折大龄儿童的临床资料。其中19例采用TEN固定（A组），16例采用锁定加压钢板固定（B组）。两组患儿在年龄、性别、患侧、骨折原因、骨折类型及受伤至手术时间等方面差异无统计学意义（P>0.05）。记录并比较两组患儿的透视次数、手术时间、术中出血量、骨折愈合时间。根据Sanders评分及Flynn疗效评分评估肢体功能。
所有患儿均获随访，随访时间6~24个月，平均11.46个月。A组手术时间、术中出血量及骨折愈合时间均明显少于B组，但A组透视次数明显多于B组（P<0.05）。所有骨折均愈合，未出现螺钉断裂、深部组织感染及神经损伤、股骨头坏死等并发症。末次随访时，根据Sanders评分，A组优14例，良4例，可1例，优良率94.74%；B组优12例，良3例，可1例，优良率93.75%，两组比较差异无统计学意义（P=0.400，P=0.980）。根据Flynn疗效评分，A组优13例，良5例，可1例，优良率为94.74%；B组优11例，良3例，可2例，优良率为87.50%，两组比较差异无统计学意义（P=0.748，P=0.688）。
TEN与锁定加压钢板治疗小儿股骨转子下骨折均有满意疗效。与锁定加压钢板相比，TEN创伤小、安全性高、骨折愈合快。
