1 Division of Orthopedics and Trauma Surgery, University of Perugia, "S. Maria della Misericordia" Hospital, Perugia, Italy.
Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy.
Acta Biomed. 2021 Sep 2;92(4):e2021249. doi: 10.23750/abm.v92i4.10387.
Over the last 20 years, the incidence of pediatric femoral shaft fractures was increased, due to changes in the children's daily activities. The healing times are different according to the chosen treatment and to other factors such as age, type of fracture, the involvement of the soft tissues, and concomitance with other injuries. The Bisaccia and Meccariello technique ( Intramedullary titanium nail Osteosynthesis Linked External-fixator -IOLE) was born to prevent rotationally and lengthening malunion or nonunion in the treatment of pediatric femoral shaft fractures. The aim or the objective of this paper is to compare the IOLE with the two most used methods for the treatment of femoral fractures in children.
From 2000 to 2016, 58 pediatric patients with femoral shaft fractures were surgically treated and enrolled in the study. The ranged age of the patients was between 3 and 15 years. Twenty-two patients were treated with endomedullary titanium nails (TEN), 16 with external axial or modular external fixators and 14 patients treated with IOLE technique. The IOLE technique is the hybridization of titanium intramedullary nails with a modular external fixator. It is divided into three phases, the first revenue given the length of the femur with the external fixator; the second, the rotations are dominated by the elastic nails; and the third finally they are hybridized on the external fixator. Comparing the three groups, radiographic images were taken to assess fracture reduction and consolidation. RESULTS: At the final follow-up, there were no differences between three groups in terms of significant rotation defects, angulation, growth, and/or nonunion but there was a statistical in IOLE groups for the early weight-bearing.
The Bisaccia- Meccariello technique (IOLE) showed to lead to healing the pediatric femoral shaft fracture of the femur but allows an early weight-bearing to these patients and normal life like that.
在过去的 20 年中，由于儿童日常活动的变化，小儿股骨干骨折的发病率有所增加。愈合时间因所选择的治疗方法以及其他因素而异，例如年龄、骨折类型、软组织受累情况以及是否合并其他损伤。Bisaccia 和 Meccariello 技术（髓内钛钉骨内固定-外固定器 -IOLE）的诞生是为了防止儿童股骨干骨折治疗中旋转和延长性畸形或不愈合。本文的目的是将 IOLE 与治疗儿童股骨干骨折的两种最常用方法进行比较。
2000 年至 2016 年，58 例小儿股骨干骨折患者接受手术治疗并纳入研究。患者年龄在 3 至 15 岁之间。22 例患者采用髓内钛钉（TEN）治疗，16 例采用外轴或模块式外固定器治疗，14 例患者采用 IOLE 技术治疗。IOLE 技术是将钛制髓内钉与模块式外固定器杂交。它分为三个阶段，第一阶段通过外固定器确定股骨的长度；第二阶段，旋转由弹性钉控制；第三阶段最终将其杂交到外固定器上。比较三组，拍摄 X 线片评估骨折复位和愈合情况。
末次随访时，三组在旋转畸形、成角、生长和/或不愈合方面无明显差异，但 IOLE 组在早期负重方面有统计学意义。
Bisaccia-Meccariello 技术（IOLE）可使小儿股骨干骨折愈合，但允许患者早期负重并恢复正常生活。
