儿童四肢长管状骨骨折的微创手术治疗

 

摘要 目的 探讨使用可吸收钉棒治疗部分儿童四肢骨干和干骺端骨折的适应症和技巧。方法：使用超高分子聚-DL-乳酸（PDLLA）制成的可吸收钉棒治疗部分儿童四肢骨干和干骺端骨折56例。小切口切开复位后一至三枚钉棒内固定，术中检查稳定性是否良好；术后肢体行石膏或支具外固定3~8周，2~3周后间断拆石膏进行关节功能训练，3~4周定期复查X线片，观察骨痂生长情况。检查肢体功能和拆石膏前后在医生指导下逐步康复训练。结果：随访44例，患者术后平均随访5.5月（3-12月）。全部骨折无移位，均愈合良好伤口无红肿渗出，无细菌感染。结论：小切口PDLLA可吸收钉棒治疗部分儿童四肢骨干和干骺端骨折，操作简单，创伤小，效果理想，避免二次手术，是治疗小儿四肢长管状骨骨折比较理想的方法之一，可以选择使用。武汉协和医院小儿骨科李进

关键词  儿童 四肢骨折  可吸收钉钉棒  治疗

 

Treatment the Long Tubular Bones Fracture of Children Limbs with PDLLA Absorbable Screw

LI Jin, DU Jingyuan，LIU Jianxiang, et al.

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 430022

 

Abstract    Objective  To discuss the indication and the technology of treatment of long tubular bone fracture of the Limbs of Children with controlled absorbable PDLLA screw or stick. Methods  56 patients with the Limbs’ Fracture of children were treated by open reduction with mini-incision and internal fixation with one to three PDLLA absorbable screw. Checked the stability of the fracture bone. After operation, give external fixation by plaster or orthosis for three to eight weeks. Two to three weeks after operation, begin to make interruptable joint functional training. Checked the X ray every three to four weeks in order to observe the bony callus. Make joint exercise by the direction of docter around the time of tearing open the plaster. Results The 44 patients were followed up from 3 to 12 months(mean, 5.5 months). No displace of bone frature and union within normal time. The wounds have not red swelling of the skin and effusion. No bacterial infection. Conclusion Treatment of the Limbs’ long tubular bone fractures of children with mini-incision and internal fixation with absorbable screw or stick is an effective method. If giving operation carefully and making appropriate training after-opertion, the complications should be avoided.

Keyword: limbs’ fracture of children ; absorbable screw; treatment;