Vitiello Raffaele, Lillo Marco, Donati Fabrizio, Masci Giulia, Noia Giovanni, De Santis Vincenzo, Maccauro Giulio
Università Cattolica del Sacro Cuore Roma.
Acta Biomed. 2019 Jan 14;90(1-S):110-115. doi: 10.23750/abm.v90i1-S.8109.
Femoral shaft fracture is a common traumatic musculoskeletal injures in pediatric population. The treatment of diaphyseal femoral fractures depends on age patient and pattern fracture. We present our record about the use of locking plate fixation and their outcomes.
We conduct a retrospective analysis in 22 patients, surgically treated for 26 diaphyseal femur fracture between 2008 and 2013. The mean age was 13 years. All the patients underwent a clinical and radiological follow-up for two years. We recorded time to weight bearing, time to union, complication (malalignment, dysmetria, infection), time to resumption to sport, plate removal, parents' satisfaction.
All the patients had a minimal clinical e radiological follow-up of 24 months. The average fracture healing time was of 7.4 weeks. All the patients had a full hip and knee range of movements. Fifteen patients developed minor malalignment (varovalgus or procurvatum femur) without clinical effects. No cases of infections. The mean time to a full weight bearing was 12 weeks and the return to sportive activity was 24 weeks. Four patients required a plate and screws removal. The average result of parents' satisfaction was 8/10.
Locking plate fixation is to be considered a successful way of treatment for pediatric femur fractures, especially in patients older than 6 years, head-injured or in the treatment of polytrauma. The anatomic and functional outcomes are comparable to those of other fixation techniques for this kind of fracture.
股骨干骨折是儿科常见的创伤性肌肉骨骼损伤。股骨干骨折的治疗取决于患者年龄和骨折类型。我们展示了关于使用锁定钢板固定及其结果的记录。
我们对2008年至2013年间接受手术治疗26例股骨干骨折的22例患者进行了回顾性分析。平均年龄为13岁。所有患者均接受了为期两年的临床和影像学随访。我们记录了负重时间、骨折愈合时间、并发症(畸形、运动失调、感染)、恢复运动时间、取出钢板情况以及家长满意度。
所有患者的临床和影像学随访最少为24个月。平均骨折愈合时间为7.4周。所有患者的髋关节和膝关节活动范围均正常。15例患者出现轻微畸形(股骨内翻或外翻、前凸),但无临床影响。无感染病例。完全负重的平均时间为12周,恢复体育活动的时间为24周。4例患者需要取出钢板和螺钉。家长满意度的平均评分为8/10。
锁定钢板固定被认为是治疗儿童股骨骨折的一种成功方法,尤其是对于6岁以上、头部受伤或多发伤患者。这种骨折的解剖和功能结果与其他固定技术相当。