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首页> 外文期刊>Journal of pediatric orthopaedics. Part B >Comminuted long bone fractures in children. Could combined fixation improve the results?
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Comminuted long bone fractures in children. Could combined fixation improve the results?

机译：小儿粉碎性长骨骨折。联合固定可以改善结果吗？

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Comminuted diaphyseal fractures in the pediatric age group represent a major orthopedic problem. It is associated with a high incidence of complications and poor outcomes because of the instability and difficulty in treatment. The aim of this study was to evaluate the efficacy of combined external skeletal fixation and flexible intramedullary nails in reconstruction of comminuted diaphyseal fracture in skeletally immature patients. Combined external fixator and elastic stable intramedullary nails were used in the management of 27 pediatric patients (15 males and 12 females) with unstable comminuted diaphyseal fractures of the tibia and femur. There were 19 fractures of the femur and eight fractures of the tibia. The average age of the patients was 8.7 years (range 7-14 years) for the femur and 10.8 years (range 6-15 years) for the tibia. Fractures were classified according to the system of Winquist and Hansen as grade II (five cases), grade III (nine cases), and grade IV (13 cases). All cases were operated within 6 days (range 0-6 days) after injury. The mean follow-up period was 2.8 years (range 2-3.5 years). The average duration of the external fixation was 1.6 months for fractures of the tibia, whereas it was 1.4 months for fractures of the femur. The average time for tibia fracture union was 2.8 months for fractures of the tibia, whereas it was 1.9 months for fractures of the femur. Malalignment in varus less than 5 degrees was noted in one patient. One patient had a limb-length discrepancy of 1.5 cms. There were five cases (18.5%) with pin-tract infection. According to the Association for the Study and Application of the Methods of Ilizarov evaluation system, bone results were excellent in 23 cases (85.2%), good in three cases (11.1%), and poor in one case (3.7%). Functional results were excellent in 22 (81.5%) cases and good in five (18.5%) cases. Combined use of external fixators and elastic intramedullary nails is a good method for the treatment of comminuted long bone fractures in children. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
机译：小儿年龄段的干干骨折代表了主要的骨科问题。由于不稳定和治疗困难，它与并发症发生率高和预后差有关。这项研究的目的是评估骨骼外固定和柔韧的髓内钉联合在骨骼未成熟患者粉碎性干phy端骨折中的疗效。结合使用外固定架和弹性稳定的髓内钉治疗27例胫骨和股骨不稳定的干端骨折的儿童患者（男15例，女12例）。有19个股骨骨折和8个胫骨骨折。股骨患者的平均年龄为8.7岁（范围7-14岁），胫骨患者的平均年龄为10.8岁（范围6-15岁）。根据Winquist和Hansen的系统将骨折分为II级（5例），III级（9例）和IV级（13例）。所有病例均在受伤后6天内（0-6天）手术。平均随访期为2.8年（范围2-3.5年）。胫骨骨折的平均外固定时间为1.6个月，而股骨骨折的平均固定时间为1.4个月。胫骨骨折的平均时间为2.8个月，而股骨骨折的平均时间为1.9个月。一名患者的内翻畸形小于5度。一名患者的肢长差异为1.5厘米。有5例（18.5％）的针道感染。根据Ilizarov评估系统方法研究与应用协会的说法，骨骼结果出色，其中23例（85.2％），好3例（11.1％）和差1例（3.7％）。功能检查结果极佳，有22例（81.5％），有5例（18.5％）良好。结合使用外固定架和弹性髓内钉是治疗儿童粉碎性长骨骨折的好方法。版权所有（C）2016 Wolters Kluwer Health，Inc.保留所有权利。

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