AIM To report the clinical and radiographic results of titanium elastic nail(TEN) in diaphyseal femoral fractures of children below age of six years.METHODS A retrospective analysis of 27 diaphyseal femoral fractures ...AIM To report the clinical and radiographic results of titanium elastic nail(TEN) in diaphyseal femoral fractures of children below age of six years.METHODS A retrospective analysis of 27 diaphyseal femoral fractures in children younger than six years treated with TEN between 2005 and 2015 was conducted. Patients were immobilized in a cast for 5 wk and the nails were removed from 6 to 12 wk after surgery. Twenty-four cases were clinically and radiographically re-evaluated using the Flynn's scoring criteria, focusing on: Limb length discrepancy, rotational deformity, angulation, hip and knee range of motion(ROM), functional status, complications, and parent's satisfaction.RESULTS Sixteen males and eight females with a mean age of 3.2 years at the time of treatment were re-evaluated at an average follow-up of 58.9 mo. No cases of delayed union were observed. The mean limb lengthening was 0.3 cm. Four cases experienced limb lengthening greater than 1 cm and always minor than 2 cm. Twelve point five percent of the cases showed an angulation < 10°. Complete functional recovery(hip and knee ROM, ability to run and jump on the operated limb) occurred in 95.7% of cases. Complications included two cases of superficial infection of the TEN entry point, one case of refracture following a new trauma, and one TEN mobilization. According to the Flynn's scoring criteria, excellent results were obtained in 79.2% of patients and satisfactory results in the remaining 20.8%, with an average parent's satisfaction level of 9.1/10.CONCLUSION TEN is as a safe, mini-invasive and surgeon-friendly technique and, considering specific inclusion criteria, it represents a useful and efficacy option for the treatment of diaphyseal femoral fractures even in patients younger than six years of age.展开更多
目的：回顾对比应用动力髋螺钉（dynamic hip screw，DHS）和股骨近端防旋髓内钉（proximal femoral nail anti-rotation，PFNA）内固定治疗老年股骨粗隆间不稳定骨折疗效优劣。方法：2004年8月至2012年8月，采用DHS和PFNA内固定治疗股...目的：回顾对比应用动力髋螺钉（dynamic hip screw，DHS）和股骨近端防旋髓内钉（proximal femoral nail anti-rotation，PFNA）内固定治疗老年股骨粗隆间不稳定骨折疗效优劣。方法：2004年8月至2012年8月，采用DHS和PFNA内固定治疗股骨粗隆间不稳定骨折92例，其中DHS组50例，男27例，女23例，平均年龄（72．5±5．3）岁；PFNA组42例，男22例，女20例，平均年龄（72．8±5．8）岁。对两组手术时间、失血量（包括隐性失血和显性失血）、卧床时间、下地负重时间、术后并发症及髋关节评分等进行比较。结果：术后随访10～18个月，平均13．5个月。PFNA组较DHS组手术时间和显性失血少，隐性失血多。PFNA组并发症发生率低于DHS组，疗效优于DHS组。髋关节Harris评分PFNA组高于DHS组。结论：治疗高龄股骨粗隆间不稳定骨折，在髋关节功能恢复和减少并发症方面，PFNA效果更好；对于Ⅱa、IIb、Ⅲ型骨折采用DHS可获取良好疗效，在减少围手术期失血方面具有优势。展开更多
目的：比较经皮加压钢板（percutaneous compressing plating，PCCP）与股骨近端防旋髓内钉（proximalfemoral nail antirotation，PFNA）治疗外侧壁危险型股骨粗隆间骨折的临床疗效。方法：自2007年9月至2010年6月，对43例外侧壁危险...目的：比较经皮加压钢板（percutaneous compressing plating，PCCP）与股骨近端防旋髓内钉（proximalfemoral nail antirotation，PFNA）治疗外侧壁危险型股骨粗隆间骨折的临床疗效。方法：自2007年9月至2010年6月，对43例外侧壁危险型股骨粗隆间骨折患者根据内固定方式分别采用PCCP和PFNA治疗。其中PCCP组22例，男9例，女13例；年龄60～86岁，平均（68．4±17．6）岁；A2．2型13例，A2．3型9例。PFNA组21例，男7例，女14例；年龄57-93岁，平均（67．7±20．1）岁；A2．2型10例，A2．3型11例。观察比较两组术中失血量、手术时间、住院时间、骨折愈合时间、并发症及术后1年Harris评分情况。结果：43例患者获得随访，平均随访18．4个月（12～22个月），全部患者获骨折愈合，恢复外伤前行走功能。两组术中失血量、手术时间、住院时间、骨折愈合时间、并发症、术后1年Harris评分比较差异无统计学意义（P〉O．05）。两组均有1例出现大粗隆顶端骨块上移、1例患髋外展无力。PCCP组1例出现螺钉断裂，PFNA组1例出现髋关节疼痛。结论：PCCP以及PFNA均能有效治疗外侧壁危险型股骨粗隆间骨折，但对于外侧壁顶端骨块移位的影响和治疗策略有待于进一步研究。展开更多
文摘AIM To report the clinical and radiographic results of titanium elastic nail(TEN) in diaphyseal femoral fractures of children below age of six years.METHODS A retrospective analysis of 27 diaphyseal femoral fractures in children younger than six years treated with TEN between 2005 and 2015 was conducted. Patients were immobilized in a cast for 5 wk and the nails were removed from 6 to 12 wk after surgery. Twenty-four cases were clinically and radiographically re-evaluated using the Flynn's scoring criteria, focusing on: Limb length discrepancy, rotational deformity, angulation, hip and knee range of motion(ROM), functional status, complications, and parent's satisfaction.RESULTS Sixteen males and eight females with a mean age of 3.2 years at the time of treatment were re-evaluated at an average follow-up of 58.9 mo. No cases of delayed union were observed. The mean limb lengthening was 0.3 cm. Four cases experienced limb lengthening greater than 1 cm and always minor than 2 cm. Twelve point five percent of the cases showed an angulation < 10°. Complete functional recovery(hip and knee ROM, ability to run and jump on the operated limb) occurred in 95.7% of cases. Complications included two cases of superficial infection of the TEN entry point, one case of refracture following a new trauma, and one TEN mobilization. According to the Flynn's scoring criteria, excellent results were obtained in 79.2% of patients and satisfactory results in the remaining 20.8%, with an average parent's satisfaction level of 9.1/10.CONCLUSION TEN is as a safe, mini-invasive and surgeon-friendly technique and, considering specific inclusion criteria, it represents a useful and efficacy option for the treatment of diaphyseal femoral fractures even in patients younger than six years of age.
文摘目的：回顾对比应用动力髋螺钉（dynamic hip screw，DHS）和股骨近端防旋髓内钉（proximal femoral nail anti-rotation，PFNA）内固定治疗老年股骨粗隆间不稳定骨折疗效优劣。方法：2004年8月至2012年8月，采用DHS和PFNA内固定治疗股骨粗隆间不稳定骨折92例，其中DHS组50例，男27例，女23例，平均年龄（72．5±5．3）岁；PFNA组42例，男22例，女20例，平均年龄（72．8±5．8）岁。对两组手术时间、失血量（包括隐性失血和显性失血）、卧床时间、下地负重时间、术后并发症及髋关节评分等进行比较。结果：术后随访10～18个月，平均13．5个月。PFNA组较DHS组手术时间和显性失血少，隐性失血多。PFNA组并发症发生率低于DHS组，疗效优于DHS组。髋关节Harris评分PFNA组高于DHS组。结论：治疗高龄股骨粗隆间不稳定骨折，在髋关节功能恢复和减少并发症方面，PFNA效果更好；对于Ⅱa、IIb、Ⅲ型骨折采用DHS可获取良好疗效，在减少围手术期失血方面具有优势。
文摘目的：比较经皮加压钢板（percutaneous compressing plating，PCCP）与股骨近端防旋髓内钉（proximalfemoral nail antirotation，PFNA）治疗外侧壁危险型股骨粗隆间骨折的临床疗效。方法：自2007年9月至2010年6月，对43例外侧壁危险型股骨粗隆间骨折患者根据内固定方式分别采用PCCP和PFNA治疗。其中PCCP组22例，男9例，女13例；年龄60～86岁，平均（68．4±17．6）岁；A2．2型13例，A2．3型9例。PFNA组21例，男7例，女14例；年龄57-93岁，平均（67．7±20．1）岁；A2．2型10例，A2．3型11例。观察比较两组术中失血量、手术时间、住院时间、骨折愈合时间、并发症及术后1年Harris评分情况。结果：43例患者获得随访，平均随访18．4个月（12～22个月），全部患者获骨折愈合，恢复外伤前行走功能。两组术中失血量、手术时间、住院时间、骨折愈合时间、并发症、术后1年Harris评分比较差异无统计学意义（P〉O．05）。两组均有1例出现大粗隆顶端骨块上移、1例患髋外展无力。PCCP组1例出现螺钉断裂，PFNA组1例出现髋关节疼痛。结论：PCCP以及PFNA均能有效治疗外侧壁危险型股骨粗隆间骨折，但对于外侧壁顶端骨块移位的影响和治疗策略有待于进一步研究。
