Rahman M M, Kabir S J, Islam N A, Saha M K, Islam M S, Islam M A, Rahman M M, Hossain M Z, Rahman A M, Sayed A, Islam M N, Kabir K M, Hossain A
Dr Md Matiur Rahman, Assistant Professor, Department of Orthopaedics, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2020 Oct;29(4):823-828.
Femoral fractures are frequent in the pediatric population. Treatment options are based on the patient's age, fracture pattern, type of trauma and associated soft tissue injury. The traditional treatment method for pediatric femoral shaft fracture has been traction and spica casting. The immediate spica cast is safe and effective for children up to 6 years of age with isolated femoral fracture and acceptable reduction. Patients between 6 and 10 years of age can also be treated with spica casting with or without traction. This prospective study was done in the department of Orthopaedics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh form from July 2015 to June 2019 to evaluate the outcome of closed reduction and internal fixation by titanium elastic nailing for fracture shaft of femur. Twenty patients, all presenting with fresh diaphyseal fractures of femur, treated with closed reduction and internal fixation by titanium elastic nailing. These patients were prospectively evaluated over a period of at least 18 months. Fractures were classified according to Association of Orthopaedics (AO) classification of shaft of femur fractures. According to AO classification, all were A1, A2, A3 fractures. Average age of the patients was 11±2.7 years; range was 6 to 16 years. There were 15 males and 5 females. Out of 20 cases treated with this method, stable fixation and union was achieved in all of them. Radiological union was achieved at an average of 10±2.3 weeks (8-15 weeks). The results were excellent in twelve patients (60%), successful in five (25%) and poor in three patients (15%) as per the scoring criteria for TEN. The effective treatment of diaphyseal fractures of the femur is intramedullary fixation by titanium elastic nailing in patients of the 6-16 years age group.
股骨骨折在儿科人群中很常见。治疗方案基于患者的年龄、骨折类型、创伤类型以及相关的软组织损伤情况。小儿股骨干骨折的传统治疗方法一直是牵引和髋人字石膏固定。对于6岁以下单纯性股骨骨折且复位良好的儿童，立即应用髋人字石膏是安全有效的。6至10岁的患者也可采用有或无牵引的髋人字石膏固定治疗。这项前瞻性研究于2015年7月至2019年6月在孟加拉国迈门辛市迈门辛医学院医院骨科进行，旨在评估钛弹性髓内钉闭合复位内固定治疗股骨干骨折的疗效。20例患者均为新鲜股骨干骨折，采用钛弹性髓内钉闭合复位内固定治疗。对这些患者进行了至少18个月的前瞻性评估。骨折根据骨科协会（AO）股骨干骨折分类进行分类。根据AO分类，所有骨折均为A1、A2、A3型骨折。患者的平均年龄为11±2.7岁；年龄范围为6至16岁。其中男性15例，女性5例。采用该方法治疗的20例病例均实现了稳定固定和骨折愈合。平均在10±2.3周（8 - 15周）实现了影像学骨折愈合。根据钛弹性髓内钉（TEN）评分标准，12例患者（60%）结果为优，5例（25%）为良，3例患者（15%）为差。对于6 - 16岁年龄组的股骨干骨折患者，有效的治疗方法是钛弹性髓内钉髓内固定。
