摘要
目的比较儿童股骨转子下骨折保守治疗与微创手术治疗的放射学结果及临床疗效。方法对2002年4月-2006年4月45例年龄3～15岁的股骨转子下骨折患儿，分别采用保守治疗（皮或骨牵引加髋人字石膏固定治疗16例）及微创手术治疗（克氏针结合石膏外固定治疗19例，弹性髓内钉固定10例），对本组患儿的放射学结果、髋关节功能及并发症等资料进行回顾性研究。结果全部病例获24~60个月随访，45例骨折都一次愈合，愈合时间为8～17周（平均10．5周）。早期放射学结果按Beaty标准：保守治疗组结果满意占37．50％．微创手术治疗组为89．66％。晚期放射学结果按Theologis标准：保守治疗组结果满意占62．50％，微创手术治疗组为96．55％。上述差异均有统计学意义（P〈0．05）。髋关节功能按Sanders标准：保守治疗组优12例，良4例，微创手术治疗组优28例，良1例，差异有统计学意义（P〈0．（15）。结论微创手术治疗比保守治疗能获得更满意的早、晚期放射学结果，并发症更少，临床疗效更满意。
Objective To compare the radiographic and functional outcomes of conservative and minimally invasive operation in treatment of subtrochanteric femur fractures in children. Methods From Apr, 2002 to Apr, 2006. forty-five children aged from 3 to 15 years with subtrochanteric femur fractures were treated with traction and hip spica cast （16 cases）, Kirschner wiring combined with hip spica cast （19 cases） and elastic intramedullary nailing （10 cases）. Results All patients were followed up for 24 to 60 mouths. All patients got their fractures healed after 8 17 weeks （average, 10. 5 weeks） post operation. Sixteen （37. 50%） treated with conservative treatment yielded satisfactory early radiological outcomes （evaluated by Beaty criterion） and 62.50% showed satisfactory late radiologi cal outcomes （evaluated by Theologis criterion）. Patients treated surgically yielded better results with 89.66% with early satisfactory radiological outcomes and 96. 55% with late satisfactory radiological outcomes （P〈0. 05）. By Sanders scoring, 12 cases get excellent femoral articulation function, 4 with good in conservative treatment group, while 28 with excellent and i with good in the operative group （P〈0.05）. Conclusions and late radiological results with subtrochanteric femur Minimally invasive operative methods provides more satisfactory in early as well as better functional outcomes than conservative method for children fractures.
出处
《中华小儿外科杂志》
CSCD
北大核心
2009年第8期518-521,共4页
Chinese Journal of Pediatric Surgery
关键词
转子下骨折
外科手术
微创性
Subtrochanteric fractures
Surgical procedures,minimally invasive
