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[1]屈繼寧,張銀剛,袁啟令,等.彈性髓內(nèi)釘內(nèi)固定與鋼板內(nèi)固定治療兒童四肢長骨骨折的比較研究[J].中醫(yī)正骨,2017,29(02):6-10.
　QU Jining,ZHANG Yingang,YUAN Qiling,et al.A comparative study of internal fixation with elastic intramedullary nail versus steel plate for treatment of long bone fractures of limbs in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(02):6-10.
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彈性髓內(nèi)釘內(nèi)固定與鋼板內(nèi)固定治療兒童四肢長骨骨折的比較研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年02期
頁碼:
6-10
欄目:
臨床研究
出版日期:
2017-02-20

文章信息/Info

Title:
A comparative study of internal fixation with elastic intramedullary nail versus steel plate for treatment of long bone fractures of limbs in children
作者:
屈繼寧; 張銀剛; 袁啟令; 劉亮
西安交通大學第一附屬醫(yī)院,陜西 西安 710061
Author(s):
QU Jining; ZHANG Yingang; YUAN Qiling; LIU Liang
The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shanxi,China
關鍵詞:
骨折;  四肢;  骨干;  兒童;  骨折固定術; 內(nèi);  彈性髓內(nèi)釘;  鋼板;  臨床試驗
Keywords:
fractures; bone;  extremities;  diaphyses;  child;  fracture fixation; internal;  elastic intramedullary nail;  steel plate;  clinical trial
摘要:
目的:比較彈性髓內(nèi)釘內(nèi)固定與鋼板內(nèi)固定治療兒童四肢長骨骨折的臨床療效和安全性。方法:將100例四肢長骨骨折患兒隨機分為2組,其中采用彈性髓內(nèi)釘內(nèi)固定術50例,采用鋼板內(nèi)固定術50例。男77例,女23例。年齡3～14歲,中位數(shù)9歲。上肢骨折58例,下肢骨折42例; 螺旋形骨折20例,斜形骨折41例,橫形骨折39例。比較2組患兒手術時間、術中出血量、住院時間、骨折愈合時間及并發(fā)癥發(fā)生情況,并于術后6個月比較2組患兒的臨床療效。結果:2組患兒手術時間比較,差異無統(tǒng)計學意義[(40.60±8.50)min,(48.00±9.33)min,t=3.230,P=0.430]; 彈性髓內(nèi)釘組術中出血量小于鋼板內(nèi)固定組[(50.60±18.35)mL,(165.30±35.80)mL,t=6.674,P=0.000],住院時間和骨折愈合時間短于鋼板內(nèi)固定組[(6.50±2.75)d,(14.75±4.40)d,t=5.785,P=0.000;(55.62±7.55)d,(80.30±8.96)d,t=4.477,P=0.034]。術后6個月,參照《常見疾病的診斷與療效判定(標準)》中肢體關節(jié)功能評價標準評價臨床療效,彈性髓內(nèi)釘組優(yōu)40例、良9例、可1例,鋼板內(nèi)固定組優(yōu)36例、良12例、可2例; 2組患兒臨床療效比較,差異無統(tǒng)計學意義(Z=-0.956,P=0.339)。2組患兒骨折斷端對位對線均良好,均無骨折不愈合或延遲愈合、釘?shù)栏腥尽⒐撬柩椎炔l(fā)癥發(fā)生。結論:對于四肢長骨骨折患兒而言,彈性髓內(nèi)釘內(nèi)固定與鋼板內(nèi)固定在臨床療效、安全性方面比較無明顯差異,但前者較后者能夠減輕創(chuàng)傷、減少出血量、縮短住院時間和骨折愈合時間,值得臨床推廣應用。
Abstract:
Objective:To compare the clinical curative effect and safety of internal fixation with elastic intramedullary nail versus steel plate in the treatment of long bone fractures of limbs in children.Methods:One hundred children with long bone fractures of limbs were randomly divided into 2 groups.Fifty children were treated with elastic intramedullary nail internal fixation(group A),while the others were treated with steel plate internal fixation(group B).The children consisted of 77 males and 23 females,and ranged in age from 3 to 14 years(Median=9 yrs).The fractures located in upper limb for 58 children and lower limb for 42 children.The fractures belonged to spiral fractures(20),oblique fractures(41)and transverse fractures(39).The operative time,blood loss,hospital stay,fracture healing time and complications were recorded and compared between the 2 groups,and the clinical curative effect were also compared between the 2 groups at 6 months after surgery.Results:There was no statistical differencs in the operative time between the two groups(40.60+/-8.50 vs 48.00+/-9.33 min,t=3.230,P=0.430).The blood loss were less in group A compared to group B(50.60+/-18.35 vs 165.30+/-35.80 ml,t=6.674,P=0.000).The hospital stays and fracture healing time were shorter in group A compared to group B(6.50+/-2.75 vs 14.75+/-4.40 days,t=5.785,P=0.000; 55.62+/-7.55 vs 80.30+/-8.96 days,t=4.477,P=0.034).At 6 months after surgery,the clinical curative effects were evaluated according to the therapeutic effect standard of limb and joint function extracted from Standard for diagnosis and curative effect evaluation of common diseases.Forty children obtained an excellent result,9 good and 1 fair in the group A; while 36 children obtained an excellent result,12 good and 2 fair in the group B.There were no statistical differences in the clinical curative effects between the two groups(Z=-0.956,P=0.339).Satisfactory paratope and alignment of fractures were obtained in all children and no complications were found such as disunion or delayed union of fractures,pin track infection and osteomyelitis.Conclusion:There are no significant difference in the clinical curative effects and safety between elastic intramedullary nail internal fixation and steel plate internal fixation for treatment of long bone fractures of limbs in children,however,the former surpasses the latter in alleviating trauma, decreasing blood loss and shortening hospital stays and fracture healing time,so it is worthy of popularizing in clinic.

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備注/Memo

備注/Memo:
基金項目:國家自然科學基金項目(81371987)
通訊作者:張銀剛 E-mail:[email protected]
更新日期/Last Update: 2017-08-07