骨骺滑动钢板固定复杂儿童股骨远端骨折

Pediatric physeal slide-traction plate for fixation of complex distal femoral fractures in children

摘要:

[目的] 探讨骨骺滑动钢板 (pediatric physeal slide-traction plate, PPSP) 在复杂儿童股骨远端骨折中的临床疗效。 [方法] 2018 年 3 月—2020 年 3 月，对 20 例复杂股骨远端骨折的患儿行手术治疗。分析围手术期、随访及影像资料。[结果] 所有患儿均顺利完成手术，无严重并发症，随访时间均超过 12 个月。完全负重活动时间为 9.5~12.0 周，平均(10.7±0.5)周。 术后随时间推移，膝 HSS 评分、膝屈-伸 ROM 显著增加(P＜0.05)；影像方面，所有患者股骨生长长度显著增加(P＜0.05)，双侧肢体长度差(LLD)、外侧股骨远端机械角(mLDFA)无明显改变(P＞0.05)；相应时间点，患侧与健侧股骨生长长度无明显差异(P＞0.05)。[结论]PPSP 固定可靠，不限制骨骺纵向生长，是治疗复杂儿童股骨远端骨折的有效选择。

关键词:骨骺滑动钢板;股骨远端骨折;内固定;儿童

Abstract:

[Objective] To explore the clinical outcomes of pediatric physeal slide-traction plate (PPSP) for internal fixation of complex distal femoral fractures in children. [Methods] From March 2018 to March 2020, 20 children received open reduction and internal fixation with PPSP for complex distal femoral fractures. The perioperative, follow-up and imaging data were evaluated. [Results] All patients opera- tion performed smoothly without serious complications, and were followed up for more than 12 months. The time to resume full-weight bear- ing activity ranged from 9.5 to 12.0 weeks with an average of (10.7±0.5) weeks. The knee HSS score and ROM increased significantly over time after operation (P＜0.05) . In terms of imaging evaluation, the growth length of femur in all patients increased significantly (P＜0.05) , but the leg length discrepancy (LLD) and the mechanical lateral distal femord angle (mLDFA) remained unchanged significantly (P＞0.05) . At any corresponding time point, there was no significant difference in the femoral growth length between the affected side and the healthy side (P＞0.05) . [Conclusion] PPSP has the advantages of reliable fixation and no restriction on the longitudinal growth of epiphysis, which is an effective choice for the treatment of complex distal femoral fractures in children.

Key words:pediatric physeal slide-traction plate; distal femoral fracture; internal fixation; children