小夹板与石膏裤治疗6月~4岁儿童闭合性股骨干骨折的疗效分析

Curative Effect of Small Splint and Plaster Trousers on Closed Femoral Shaft Fracture in Children Aged 6 Months - 4 Years Old

摘要: 目的：比较早期小夹板固定与石膏裤固定两种方法治疗儿童(6月~4岁)股骨干骨折的临床疗效和安全性。方法：本研究为回顾性研究，选取我院2013年2月至2022年5月收治儿童股骨干骨折患儿共100例，排除5例，95例患儿纳入本研究。随机将患儿分为A、B两组。A组50例患儿运用闭合复位小夹板加皮肤牵引固定，B组45例患儿均早期在麻醉下行闭合复位石膏裤固定。统计随访分析术后2年内临床疗效和安全性。平均随访25个月(17个月~28个月)。结果：两组患儿骨折愈合时间、畸形愈合发生率、并发症发生率及术后功能恢复情况无统计学差异(P > 0.05)。早期石膏固定治疗组可发生成角和短缩移位，小夹板固定组并未发现成角和短缩加大的情况。结论：手法整复小夹板外固定结合皮肤牵引能有效治疗6月~4岁闭合性移位性股骨干骨折，创伤小，费用低，操作简便，无麻醉风险，骨折愈合率及功能恢复情况与传统石膏裤固定并无差异，并发症少，值得临床推广。

Abstract: Objective: To compare the clinical efficacy and safety of early small splint plus skin traction fixation and plaster pants fixation in the treatment of femoral shaft fractures in children (6 months ~ 4 years old). Methods: From February 2013 to May 2021, 100 children with femoral shaft fracture were treated in our hospital, 5 cases were excluded, and 95 children were included in this study. The children were randomly divided into group A and group B. 50 children in group A were treated with traction and small splint external fixation, and 45 children in group B were treated with closed reduction and plaster pants fixation under early anesthesia. The clinical efficacy and safety within 2 years after operation were analyzed. Results: There was no significant difference in fracture healing time, malunion rate, complication rate and postoperative functional recovery between the two groups (P > 0.05). In the early plaster fixation group, angular enlargement can occur, and children with large initial shortening are also prone to shortening and enlargement; In the splint fixation group, there was no increase in angle and shortening. Conclusion: Manual reduction, small splint external fixation and skin traction can effectively treat closed displaced femoral shaft fractures aged from 6 months to 4 years. It has the advantages of small trauma, low cost, simple operation, no dif-ference between fracture healing rate and functional recovery and traditional plaster pants fixation, and less complications. It is worthy of clinical promotion.