中国修复重建外科杂志

中国修复重建外科杂志

闭合复位联合 Taylor 三维空间支架固定治疗儿童股骨髁上骨折

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目的探讨闭合复位联合 Taylor 三维空间支架固定治疗儿童股骨髁上骨折的疗效及安全性。方法2008 年 7 月—2016 年 7 月,采用闭合复位联合 Taylor 三维空间支架固定治疗儿童股骨髁上骨折 20 例。其中,男 14 例,女 6 例;年龄 6~14 岁,平均 10.3 岁。致伤原因:交通事故伤 5 例,高处坠落伤 6 例,摔伤 9 例。均为闭合性骨折;屈曲型 12 例,伸直型 8 例。根据 AO 分型:A1 型 12 例,A2 型 8 例。骨折位于骨骺线上 0.5~5.0 cm,平均 2.5 cm。受伤至手术时间 2~8 d,平均 3.5 d。术后采用膝关节 Kolment 评定标准评价膝关节功能。结果术后患儿均获随访,随访时间 6~24 个月,平均 18.1 个月。术后均无钉道感染、血管神经损伤、外固定架松动、骨折移位、再骨折等并发症发生。所有骨折均愈合,愈合时间 4~6 周,平均 4.5 周。拆除支架时间为 8~12 周,平均 9.5 周。患儿无跛行步态,膝关节功能恢复良好,无骨骺发育异常。末次随访时,参照膝关节 Kolment 评定标准,获优 18 例、良 2 例,优良率为 100%。结论闭合复位联合 Taylor 三维空间支架固定治疗儿童股骨髁上骨折,具有创伤小、恢复快、能避免对骺板的损伤,骨折愈合率高,能促进患肢功能恢复等优点,是有效治疗手段之一。

ObjectiveTo evaluate the effectiveness and safety of closed reduction combined with Taylor three-dimensional space stent fixation in treatment of supracondylar femoral fractures in children.MethodsBetween July 2008 and July 2016, 20 patients with supracondylar femoral fractures were treated with closed reduction combined with Taylor three-dimensional space stent fixation. There were 14 males and 6 females, with an average of 10.3 years (range, 6-14 years). The cause of injury was traffic accident in 5 cases, falling from high place in 6 cases, and falling in 9 cases. All fractures were closed fractures; Among them, 12 cases were flexion type and 8 cases were straight type. According to AO classification, 12 cases were rated as type A1 and 8 cases as type A2. The fractures were over 0.5 to 5.0 cm (mean, 2.5 cm) of the epiphysis line. The time from injury to surgery was 2-8 days (mean, 3.5 days). Preoperative knee joint function was evaluated based on the Kolment evaluation criteria.ResultsAll children were followed up 6-24 months (mean, 18.1 months). There was no complication such as nail infection, vascular nerve injury, external fixation looseing, fracture displacement, or re-fracture. All fractures healed and the fracture healing time was 4-6 weeks with an average of 4.5 weeks. The gait and knee function recovered, and there was no abnormality of the epiphysis. At last follow-up, 18 cases were excellent and 2 cases were good according to the Kolment evaluation criteria, and the excellent and good rate was 100%. ConclusionClosed reduction combined with Taylor three-dimensional space stent fixation is an effective treatment for the children with supracondylar femoral fractures, with small trauma and rapid recovery. It can avoid damaging the tarsal plate, be high fracture healing rate, and promote the recovery of limb function.

关键词: Taylor三维空间支架; 股骨髁上骨折; 闭合复位; 外固定; 儿童

Key words: Taylor three-dimensional space stent; supracondylar femoral fracture; closed reduction; external fixation; child

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