Department of Orthopaedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Orthop Surg. 2021 Jun;13(4):1336-1342. doi: 10.1111/os.12977. Epub 2021 May 7.
The aim of the present paper was to investigate the clinical efficacy of minimally invasive elastic stable intramedullary nailing (ESIN) for long bone fractures in children.
A total of 350 children with limb fractures from June 2012 to June 2018 were recruited and randomized into two groups: an ESIN group (n = 175) treated with elastic stable intramedullary nailing, and an MPIF group (n = 175), treated with metal plate internal fixation. Both groups received the same physical examination and routine medication. Operation related indexes, clinical efficacy, complications, and postoperative quality of life scores were analyzed and compared.
The operation time, intraoperative blood loss, hospitalization time, and fracture healing time in the ESIN group were 43.74 ± 4.96 min, 8.14 ± 1.34 mL, 5.97 ± 1.88 days, and 55.89 ± 5.61 days, respectively, which were all significantly less than those in the MPIF group (all P < 0.001). In terms of common complications after limb fracture treatment, there were 6 cases of osteomyelitis, 5 cases of skin irritation response, and 7 cases of inflammatory granuloma in the MPIF group. There were 2 cases of skin irritation response and 5 cases of inflammatory granuloma in the ESIN group. The incidence of postoperative complications in the ESIN group was 4.00%, which was significantly lower than that in MPIF group (10.29%) (P < 0.05). The effective rate for recovery condition in the ESIN group (93.71%) was significantly higher than that in the MPIF group (P < 0.001). The quality of life scores after treatment in both groups were improved, while the score in the ESIN group was significantly higher than that in the MPIF group (79.43%) (P < 0.001). The postoperative satisfaction rate in the ESIN group (94.29%) was significantly higher than that in the MPIF group (86.29%) (P < 0.05). The quality of life scores after treatment in both groups were improved, while the score in the ESIN group was significantly higher than that in the MPIF group (P < 0.001). The postoperative satisfaction rate and the acceptance rate for adjacent joint function in the ESIN group (100%) were significantly higher than those in the MPIF group (92.00%) (P < 0.0001).
Elastic stable intramedullary nailing is a minimally invasive procedure for long bone fractures in children. It can effectively improve the operation-related indicators and postoperative quality of life and reduce the incidence of complications.
本研究旨在探讨微创弹性髓内钉(ESIN)治疗儿童长骨骨折的临床疗效。
选取 2012 年 6 月至 2018 年 6 月收治的 350 例肢体骨折患儿,采用随机数字表法分为 ESIN 组(n=175)和 MPIF 组(n=175)。ESIN 组采用 ESIN 治疗,MPIF 组采用金属板内固定治疗。两组患儿均接受相同的体格检查和常规药物治疗。分析比较两组患儿的手术相关指标、临床疗效、并发症及术后生活质量评分。
ESIN 组手术时间、术中出血量、住院时间和骨折愈合时间分别为 43.74±4.96 min、8.14±1.34 mL、5.97±1.88 d 和 55.89±5.61 d,均显著短于 MPIF 组(均 P<0.001)。在肢体骨折治疗后的常见并发症方面,MPIF 组发生骨髓炎 6 例、皮肤刺激反应 5 例、炎性肉芽肿 7 例,ESIN 组发生皮肤刺激反应 2 例、炎性肉芽肿 5 例。ESIN 组术后并发症发生率为 4.00%,显著低于 MPIF 组的 10.29%(P<0.05)。ESIN 组治疗后恢复情况的有效率为 93.71%,显著高于 MPIF 组(P<0.001)。两组患者治疗后的生活质量评分均提高,且 ESIN 组显著高于 MPIF 组(P<0.001)。ESIN 组的术后满意度为 94.29%,显著高于 MPIF 组的 86.29%(P<0.05)。ESIN 组对关节功能的接受率和术后满意度(均为 100%)均显著高于 MPIF 组(分别为 92.00%和 96.67%)(均 P<0.0001)。
微创弹性髓内钉治疗儿童长骨骨折是一种微创术式,可有效改善手术相关指标及术后生活质量,降低并发症发生率。