Khan Abdul Qayyum, Julfiqar Mohd, Jilani Latif Zafar, Istiyak Mohammad
Department of Orthopaedic Surgery, J.N. Medical College, Faculty of Medicine, A.M.U Aligarh, Uttar Pradesh, India.
Int J Burns Trauma. 2023 Dec 15;13(6):214-221. eCollection 2023.
The management of adolescent femur fractures continues to evolve and remains controversial. Currently, operative fixation methods are favoured, offering options such as external fixator, flexible and locked intramedullary nailing, compression and locked plating. Our study aims to introduce a novel approach for treating adolescent femoral shaft fractures by combining an external fixator with an elastic stable intramedullary nail.
We included 32 patients aged 11-16 years with femoral shaft fractures treated using an external fixator augmented elastic intramedullary nail at our institution from August 2015 to January 2019.
All patients achieved bony union. We analysed patient's results both clinically and radiologically. On average, the surgery took 77.34 minutes to complete with an average time to union of 13.9 weeks. External fixator and elastic nail removal took an average of 3.59 months and 26.5 months, respectively. At the final follow-up, knee range of motion averaged 131.88 degrees. According to the Flynn criteria, functional outcomes were excellent in 18 patients, satisfactory in 11 patients and poor in 3 patients. Pin site infection occurred in 3 patients, malunion in 4 patients, limb length shortening < 1 cm in 3 patients, distal nail tip prominence and knee stiffness in 3 patients.
The management of femur fractures in adolescents using an elastic nail augmented with an external fixator is a minimally invasive procedure that provide secure fracture stabilization and predictable outcomes.
青少年股骨骨折的治疗方法不断发展，仍存在争议。目前，手术固定方法更受青睐，包括外固定器、弹性和带锁髓内钉、加压和带锁钢板等选择。我们的研究旨在介绍一种将外固定器与弹性稳定髓内钉相结合治疗青少年股骨干骨折的新方法。
我们纳入了2015年8月至2019年1月在我院使用外固定器辅助弹性髓内钉治疗的32例11 - 16岁股骨干骨折患者。
所有患者均实现了骨愈合。我们从临床和影像学方面分析了患者的结果。手术平均耗时77.34分钟，平均愈合时间为13.9周。外固定器和弹性钉取出的平均时间分别为3.59个月和26.5个月。在最后一次随访时，膝关节活动范围平均为131.88度。根据弗林标准，18例患者功能结果优秀，11例患者满意，3例患者较差。3例患者发生针道感染，4例患者出现骨不连，3例患者肢体长度缩短<1cm，3例患者出现远端钉尖突出和膝关节僵硬。
使用外固定器辅助弹性钉治疗青少年股骨骨折是一种微创手术，可提供可靠的骨折固定和可预测的结果。
