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《The Journal of Traditional Chinese Orthopedics and Traumatology》 2017-02
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A comparative study of internal fixation with elastic intramedullary nail versus steel plate for treatment of long bone fractures of limbs in children

QU Jining;ZHANG Yingang;YUAN Qiling;LIU Liang;The First Affiliated Hospital of Xi'an Jiaotong University;  
Objective:To compare the clinical curative effect and safety of internal fixation with elastic intramedullary nail versus steel plate in the treatment of long bone fractures of limbs in children.Methods:One hundred children with long bone fractures of limbs were randomly divided into 2 groups.Fifty children were treated with elastic intramedullary nail internal fixation(group A),while the others were treated with steel plate internal fixation(group B).The children consisted of 77 males and 23 females,and ranged in age from 3 to 14 years(Median = 9 yrs).The fractures located in upper limb for 58 children and lower limb for 42 children.The fractures belonged to spiral fractures(20),oblique fractures(41) and transverse fractures(39).The operative time,blood loss,hospital stay fracture healing time and complications were recorded and compared between the 2 groups,and the clinical curative effect were also compared between the 2 groups at 6months after surgery.Results:There was no statistical differencs in the operative time between the two groups(40.60 +/- 8.50 vs48.00 +/-9.33 min,t =3.230 P = 0.430).The blood loss were less in group A compared to group B(50.60 +/- 18.35 vs 165.30 +/-35.80 ml p =6.614,P =0.000).The hospital stays and fracture healing time were shorter in group A compared to group B(6.50 +/-2.75 vs 14.75 +/-4.40 days,t=5.785,P =0.000;55.62+/-1.55 vs 80.30 +/-8.96 days,t =4.477 P = 0.034).At 6 months after surgery,the clinical curative effects were evaluated according to the therapeutic effect standard of limb and joint function extracted from Standard for diagnosis and curative effect evaluation of common diseases.Forty children obtained an excellent result,9 good and 1 fair in the group A;while 36 children obtained an excellent result,12 good and 2 fair in the group B.There were no statistical differences in the clinical curative effects between the two groups(Z =-0.956 P =0.339).Satisfactory paratope and alignment of fractures were obtained in all children and no complications were found such as disunion or delayed union of fractures,pin track infection and osteomyelitis.Conclusion:There are no significant difference in the clinical curative effects and safety between elastic intramedullary nail internal fixation and steel plate internal fixation for treatment of long bone fractures of limbs in children,however,the former surpasses the latter in alleviating trauma,decreasing blood loss and shortening hospital stays and fracture healing time,so it is worthy of popularizing in clinic.
【Fund】: 国家自然科学基金项目(81371987)
【CateGory Index】: R726.8
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