摘要
目的探讨儿童髋部锁定加压接骨板和空心钉治疗儿童股骨颈骨折（DelbetⅡ、Ⅲ型）的治疗效果。方法收集2011年6月至2015年6月间厦门大学附属福州第二医院、湖南省儿童医院、佛山市中医院、华中科技大学同济医学院附属同济医院、广州市妇女儿童医疗中心、华中科技大学同济医学院附属协和医院和大连医科大学附属大连儿童医院，因股骨颈骨折（DelbetⅡ、Ⅲ型）接受儿童髋部锁定加压接骨板和空心钉内固定治疗114例患儿的临床资料。其中，男68例，女46例。受伤年龄3．0～14．0岁，平均9．30岁。骨折分型：DelbetⅡ型83例，Ⅲ型31例。行儿童髋部锁定加压接骨板内固定术25例（儿童髋部锁定加压接骨板组），行空心钉内固定术89例（空心钉组）。末次随访采用Ratliff分级功能评分，并发症评估包括股骨头坏死、骨骺早闭及髋内翻等。结果术后随访12～48个月，平均23．3个月。儿童髋部锁定加压接骨板组术后Ratliff分级功能评分（优22例，良2例，差1例）优于空心钉组（优54例，良19例，差16例），差异有统计学意义（P=0．036）。儿童髋部锁定加压接骨板组术后总并发症发生率20．00％（5／25）低于空心钉组42．70％（38／89），差异有统计学意义（P=0．039），且空心钉组5例术后因内周定失效行二次翻修手术。儿童髋部锁定加压接骨板组术后影像学上达到骨性愈合的时间为（9．64±1．60）周与空心钉组（10．11±1．87）周比较，差异无统计学意义（P=0．252）。结论相对于空心钉，儿童髋部锁定加压接骨板治疗儿童股骨颈骨折（DelbetⅡ、Ⅲ型）术后Ratliff功能评分更高，并发症发生率更低，在治疗上可能更有优势。
Objective To compare the early postoperative radiological and clinical outcomes of pediatric hip plating versus cannulated screw fixation for pediatric femoral neck fractures. Methods For this retrospective comparative study, a total of 114 children of femoral neck fractures （Delbet types Ⅱ ＆ Ⅲ ） underwent pediatric hip plating and cannulated screw fixation between June 2011 and June 2015. There were 68 boys and 46 girls with an average age of 9. 30 （3.0-14. 0） years. The Delbet types were Ⅱ （n = 83） and Ⅲ （n = 31）. And the interventions included cannulated screw （n = 89） and pediatric hip plating （n = 25）. Ratliff＇s classification standard score was utilized for determining pain, function, activity and radiographic changes during the most recent follow-up. The outcomes were classified as excellent, satisfactory or poor. And the complications of osteonecrosis, epiphyseal arrest and premature physeal closure, etc were recorded. Results The average length of follow-up period was 23.32 （12-48） months. The Ratliff classification standard score was better in pediatric hip plating group （P= 0. 036）. The overall complication rate was lower in pediatric hip plating group （5/25, 20. 00%） than that in eannulated screw group （38/89, 42. 70%） （P = 0. 039）. However, time to radiographic union was comparable for two groups （9. 64 vs. 10. 11 weeks） （P = 0. 252）. Conclusions Ideal for pediatric femoral neck fracture, pediatric hip plating of pediatric femoral neck fracture yields better outcomes and lower overall complication rate than cannulated screw.
出处
《中华小儿外科杂志》
CSCD
2016年第12期898-902,共5页
Chinese Journal of Pediatric Surgery
关键词
股骨颈骨折
内固定器
疗效比较研究
Femoral neck fracture
Internal fixators
Comparative effectiveness research
