弹性髓内钉和钢板固定对儿童股骨干中段骨折的疗效比较

目的:观察并比较弹性髓内钉(ESIN)与钢板固定(PF)治疗儿童股骨干中段骨折的临床疗效。方法:选择2013年2月至2016年12月我院收治的股骨干中段骨折患儿90例,依据治疗方法不同分为ESIN组和PF组。ESIN组(n=45)采用弹性髓内钉固定,PF组(n=45)采用钢板固定,比较两组患者手术时间、手术切口、术中失血量、术后切口引流量等手术指标,随访评估患者住院时间、完全负重时间、骨折愈合时间;按Flynn评定标准比较两组患者的最终治疗结果。结果:两组患者术中失血量、术后引流量比较差异无统计学意义(P0.05),ESIN组患者手术切口显著小于PF组(P0.05),手术时间、透视时间、完全负重时间均显著短于PF组(P0.05),临床疗效明显优于PF组(P0.05)。结论:与钢板固定比较,弹性髓内钉在手术时间、透视时间显著短于钢板固定,临床疗效明显优于钢板固定,可作为儿童股骨干骨折内固定的首选材料。

Comparison of the Clinical Efficacy of Plate Fixation and Elastic Stable Intramedullary Nailing in the Treatment of Femoral Shaft Fractures in Children

ABSTRACT Objective: To observe and compare the clinical efficacy of plate fixation (PF) with elastic stable intramedullary nailing (ESIN) in the treatment of midshaft femoral fractures in children. Methods: 90 cases of pediatric midshaft femur fractures from February 2013 to December 2016 were selected and divided into two groups according to different treatment WITH45 cases in each group: elastic stable intramedullary nailing group(ESIN) and plate fixation group (PF) group. The indexes of operation time, surgical incision, intraoperative blood loss, postoperative wound drainage were compared between the two groups. The hospital stay, full weight bearing time, time of fracture healing; final functional outcomes were evaluated using Flynn''s system. Results: There was no significant difference in the blood loss and postoperative drainage between the two groups (P>0.05). The surgical incision of ESIN group was significantly smaller than that of the PF group (P<0.05). The operation time and fluoroscopy time and time of total load-bearing were significantly shorter in ESIN group (P<0.05). The therapeutic effect of ESIN group was superior to that of the PF group (P<0.05). Conclusion: Compared with the plate fixation, the operation time and the fluoroscopic time were significantly shorter in the ESIN. The clinical curative effect of ESIN was also superior to the PF in the treatment of midshaft femoral fractures in children. The elastic intramedullary nail should be the fixation material for the femoral shaft fracture in children.