Liu Chaoyu,Zhang Jianqiang,Xu Wenqiang,et al.Efficacy analysis of intramedullary nail fixation for femoral shaft fractures in adolescents via a lateral recumbent position with Steinmann pin[J].Journal of Clinical Pediatric Surgery,2024,(02):162-167.[doi:10.3760/cma.j.cn101785-202305033-012]
侧卧位斯氏针摇杆技术辅助复位髓内钉固定治疗青少年股骨骨折
- Title:
- Efficacy analysis of intramedullary nail fixation for femoral shaft fractures in adolescents via a lateral recumbent position with Steinmann pin
- 摘要:
- 目的 探讨侧卧位斯氏针摇杆技术辅助复位髓内钉内固定治疗青少年股骨干骨折的早期疗效与手术要点。方法 回顾性分析2018年6月至2021年9月由安徽医科大学附属阜阳人民医院小儿骨科应用侧卧位斯氏针摇杆技术辅助复位髓内钉内固定治疗的31例青少年股骨骨折患儿临床资料,其中男18例、女13例,年龄(13.5±2.1)岁,体重(60.2±6.5)kg,受伤至手术时间(4.4±1.8)d,左侧20例、右侧11例;收集所有患儿手术时间、住院时间、出血量、末次随访时下肢全长、股骨头最高点平面与股骨大粗隆顶点平面间距离(articulotrochanteric distance,ATD)、股骨颈最宽径(widest femoral neck diameter,FND)以及颈干角,采用Harris功能评分评估髋关节功能。结果 31例均采取侧卧位斯氏针辅助闭合复位青少年型股骨髓内钉固定治疗,手术时间(67.9±20.4)min,术中出血量(124.4±34.8)mL;31例均获随访,随访时间(22.8±5.2)个月。末次随访时髋关节功能优良率为100%(31/31),患侧及健侧下肢全长、ATD、FND、颈干角、髋关节功能评分分别为(84.2±5.1)cm比(84.1±5.2)cm、(30.3±1.4)°比(31.1±1.3)°、(27.7±1.9)°比(27.4±1.4)°、(132.0±2.9)°比(131.7±2.7)°、(95.7±2.0)分比(96.1±1.4)分,差异均无统计学意义(P＞0.05)。无一例出现感染、股骨头缺血坏死、股骨近端畸形、骨折延迟愈合及不愈合、功能障碍或内固定松动。结论 侧卧位斯氏针摇杆技术辅助复位髓内钉内固定治疗青少年股骨干骨折疗效确切,可作为临床治疗的一种可靠选择。
- Abstract:
- Objective To explore the early efficacy and surgical essentials of closed reduction intramedullary nail fixation assisted by Steinmann pin for adolescent femoral shaft fractures.Methods From June 2018 to September 2021,the relevant clinical data were retrospectively reviewed for 31 adolescents undergoing intramedullary nail fixation for femoral shaft fractures via a lateral recumbent position with Steinmann pin.There were 18 boys and 13 girls with an average age of (13.5±2.1) year,an average weight of (60.2±6.5)kg and an average time from injury to surgery of (4.4±1.8)day.The affected side was left (n=20) and right (n=11).Statistical analysis was performed for surgical duration,hospitalization stay,hemorrhagic volume,lower extremity length at the last follow-up,articulotrochanteric distance (ATD),widest femoral neck diameter (FND) and neck shaft angle.Results Closed repositioning of femoral intramedullary nail fixation was assisted by a lateral recumbent Steinman pin.Average operative duration was (67.9±20.4) min and average volume of intraoperative hemorrhage (124.4±34.8)mL.At the last follow-up,hip function was evaluated according to the Harris function score.The excellent rate was up to 100%.The average follow-up period was (22.8±5.2)(15-37) month.At the last follow-up,length of lower extremities and healthy side,ATD,FND,cervical stem angle and hip function score were (84.2±5.1) cm,(84.1±5.2) cm;(30.3±1.4)°,(31.1±1.3)°;(27.7±1.9)°,(27.4±1.4)°;(132.0±2.9)°,(131.7±2.7)°;(95.7±2.0) points,(96.1±1.4) points respectively at affected and healthy sides.There were no statistically significant differences (P>0.05).At the last follow-up,there was no occurrence of infection,ischemic necrosis of femoral head,proximal femoral deformity,delayed healing,non-healing of fracture,functional impairment,re-fracture or loosening of internal fixation.Conclusions Treating adolescent femoral shaft fractures with closed reduction intramedullary nail fixation assisted by a lateral recumbent Steinman pin may achieve an excellent reduction with a definite therapeutic efficacy.
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备注/Memo
收稿日期:2023-5-19。
通讯作者:王伟,Email:fywangwei0558@163.com