儿童股骨干骨折的规范化治疗-中国骨与关节杂志.pdfVIP

. 766 . 中国骨与关节杂志 2015 年 10 月第 4 卷第 10 期 Chinese Journal of Bone and Joint, October 2015, Vol 4, No.10 . 骨科教案 Orthopedics course . 儿童股骨干骨折的规范化治疗 张立军 DOI: 10.3969/j.issn.2095-252X.2015.10.009　　中图分类号：R726.8, R683.4 作者单位：110004 沈阳，中国医科大学附属盛京医院儿童骨科 Standardized treatment of pediatric femoral shaft fractures ZHANG Li-jun. Department of Pediatric Orthopedics, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110004, PRC Abstract Femoral shaft fracture is the most common pediatric injury. Several methods of treatment of 【 】 femoral shaft fracture can be used in children. In general, nonoperative therapy should be used in a 3 years or younger child, such as Pavlik harness, skin traction, spica casting, or spica casting followed skin traction. Femoral shaft fracture caused by birth trauma in neonate even with serious angulation deformity will turn to normal within one year after remolding. Operative therapy should be performed above 3 years old. Elastic Stabilized Intramedullary Nailing ( ESIN ) is the main operative treatment. ESIN with small incision and minimally invasive is suitable for transverse fracture and short oblique fracture. ESIN is not suitable for long oblique fracture, comminuted fracture and overweight ( 45 kg ). The plate fixation is suitable for inferior femoral lesser trochanter fracture and distal femoral metaphyseal fracture. The disadvantages of plate fixation include the long incision, severe injury, and removal of the internal fixator. The plate fixation is decreasing in the modern treatment for the femoral shaft fracture in children. Submuscular bridge plating fixation is applied to the long oblique fracture, spiral fracture, especially comminuted fracture. External fixation is suitable for the infection of bone or soft tissue and open fracture. When the patient is older than 10 years ( or less )