Debuka Ekansh, Kushwaha Narendra Singh, Kumar Dharmendra, Singh Ajai, Sharma Vineet
Department of Orthopaedics, KGMU, Lucknow, 226018, U.P., India.
J Clin Orthop Trauma. 2019 Sep-Oct;10(5):922-927. doi: 10.1016/j.jcot.2018.06.010. Epub 2018 Jun 28.
The optimal mode of treatment among the wide variety of surgical and nonsurgical treatment options for children between 5 and 15 years of age continues to be controversial. Elastic stable intramedullary nailing of long bone fractures in the skeletally immature has gained widespread popularity because of its clinical effectiveness and low risk of complications.
From Jan 2015 to August 2016, 35 patients including 37 limbs with diaphyseal fractures of the femur in the age group 5-15 years were managed by Titanium Elastic nailing and their clinico-radiological and functional outcome was assessed at 1 year post operatively as per the Flynn's criteria. RUST score was used as a guide for post-operative rehabilitation.
37 patients were managed by TENS nailing including 28 males and 9 females. The outcome in proximal, middle or distal fractures of the shaft were found to be similar and the difference was statistically insignificant. Similarly, the difference in the outcomes as per fracture patterns was also found to be statistically insignificant. Partial weight bearing was allowed after a score of 6 was achieved and full weight bearing after a score of 8.
As per the Flynn's criteria, 75% of the patients (28 out of 37) were found to have an excellent outcome while 7 had a satisfactory outcome and two had a poor outcome. RUST score can be used as an effective guide for post op rehabilitation.
对于5至15岁儿童，在众多手术和非手术治疗方案中，最佳治疗模式仍存在争议。弹性稳定髓内钉治疗骨骼未成熟儿童的长骨骨折，因其临床疗效和低并发症风险而广受欢迎。
2015年1月至2016年8月，对35例（共37肢）5至15岁股骨骨干骨折患儿采用钛弹性髓内钉治疗，并根据弗林（Flynn）标准在术后1年评估其临床放射学和功能结果。使用RUST评分指导术后康复。
37例患者采用钛弹性髓内钉治疗，其中男性28例，女性9例。发现骨干近端、中段或远端骨折的结果相似，差异无统计学意义。同样，根据骨折类型的结果差异也无统计学意义。达到6分后允许部分负重，8分后允许完全负重。
根据弗林标准，75%的患者（37例中的28例）结果优秀，7例结果满意，2例结果差。RUST评分可作为术后康复的有效指导。
