He Xiaozhang, Wang Tao, Nan Guoxin, Wang Jundong, Liao Peng, Xu Shaolin, Yu Kailong
Department of Pediatric Surgery, Pingxiang People's Hospital, Pingxiang Jiangxi, 337000, P. R. China.
Department of Pediatric Orthopedics, Municipal Children's Hospital, Guangdong Medical University, Dongguan Guangdong, 523326, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Mar 15;39(3):290-295. doi: 10.7507/1002-1892.202412087.
To investigate short-term effectiveness of using expert adolescent lateral femoral nail (EALFN) in treating femoral shaft fractures in older children and adolescents.
A retrospective analysis was conducted on the clinical data of 17 patients with femoral shaft fractures who met the inclusion criteria and were admitted between July 2020 and June 2024. All fractures were fixed with EALFN after reduction. There were 11 males and 6 females, with a mean age of 13.3 years (range, 11-16 years). The average body weight was 51.2 kg (range, 40-84 kg), and the average height was 162.1 cm (range, 150-172 cm). The causes of injury included traffic accidents ( =9), falling from height ( =1), and simple falls ( =7). One patient had an open fracture treated with an external fixator and experienced delayed fracture healing. The remaining patients were closed fractures, with an average time from injury to operation of 5.8 days (range, 2-10 days). Operation time and postoperative hospital stay were documented. During follow-up, X-ray films were taken to observe the fracture healing, and the bilateral femoral length, femoral neck-shaft angle, widest femoral neck diameter (FND), and articular trochanteric distance (ATD) were measured at last follow-up. Hip function was assessed using the Harris score. The differences in the all indicators between the healthy and affected sides were compared.
The operation time ranged from 65 to 130 minutes (mean, 94.1 minutes). Postoperative hospital stay ranged from 5 to 40 days (mean, 16.7 days). All patients were followed up 7-36 months (mean, 14.4 months). One patient exhibited delayed fracture healing during follow-up. The distal locking nail was removed at 6 months after operation, and partial weight-bearing was initiated following dynamic fracture stabilization. The fracture healing was achieved, and the intramedullary nail was removed at 24 months after operation. The other fractures healed with the healing time of 6-20 months (mean, 9.6 months), and the intramedullary nails were removed. During follow-up, no femoral fracture, abnormal development of the greater trochanter, or ischemic necrosis of the femoral head occurred. At last follow-up, there was no significant difference in femoral length, femoral neck-shaft angle, FND, ATD, or Harris score between the affected and healthy sides ( >0.05).
For older children and adolescents with femoral neck fractures, the application of EALFN fixation aligns more closely with the principles of intramedullary central fixation and rapid rehabilitation. This approach is associated with fewer complications and superior short-term effectiveness.
探讨采用专家型青少年股外侧髓内钉（EALFN）治疗大龄儿童及青少年股骨干骨折的短期疗效。
对2020年7月至2024年6月期间收治的17例符合纳入标准的股骨干骨折患者的临床资料进行回顾性分析。所有骨折均在复位后采用EALFN固定。其中男性11例，女性6例，平均年龄13.3岁（范围11 - 16岁）。平均体重51.2 kg（范围40 - 84 kg），平均身高162.1 cm（范围150 - 172 cm）。受伤原因包括交通事故（9例）、高处坠落（1例）和单纯跌倒（7例）。1例开放性骨折患者采用外固定架治疗，出现骨折延迟愈合。其余患者为闭合性骨折，受伤至手术的平均时间为5.8天（范围2 - 10天）。记录手术时间和术后住院时间。随访期间拍摄X线片观察骨折愈合情况，末次随访时测量双侧股骨长度、股骨颈干角、股骨颈最宽直径（FND）和关节转子间距离（ATD）。采用Harris评分评估髋关节功能。比较患侧与健侧各项指标的差异。
手术时间为65至130分钟（平均94.1分钟）。术后住院时间为5至40天（平均16.7天）。所有患者均随访7 - 36个月（平均14.4个月）。1例患者在随访期间出现骨折延迟愈合。术后6个月取出远端锁定钉，骨折动态稳定后开始部分负重。骨折愈合后，术后24个月取出髓内钉。其他骨折愈合时间为6至20个月（平均9.6个月），并取出髓内钉。随访期间，未发生股骨骨折、大转子异常发育或股骨头缺血坏死。末次随访时，患侧与健侧在股骨长度、股骨颈干角、FND、ATD或Harris评分方面无显著差异（P>0.05）。
对于大龄儿童及青少年股骨颈骨折，应用EALFN固定更符合髓内中心固定和快速康复的原则。该方法并发症较少，短期疗效良好。
