摘要目的 比较弹性髓内钉(TEN)与钢板治疗较大年龄(＞10岁)儿童尺桡骨双骨折的疗效. 方法 回顾分析2009-2014年儿童尺桡骨双骨折47例(50侧),其中TEN组30侧,钢板组20侧.比较两组手术时间、开放/闭合复位比例、内固定取出时间、术后并发症发生率、骨折骨性愈合时间及前臂骨折治疗效果(按Anderson法). 结果 TEN组手术时间为94.3 min,钢板组为120.5 min(P ＜0.05).TEN组内固定取出时间为210.8 d,钢板组为264.3 d(P ＜0.05).TEN组开放/闭合复位占66.7％,闭合复位占33.3％,钢板组开放复位为100％(P＜0.05).术后并发症发生率、骨折骨性愈合时间及骨折治疗效果评价差异均无统计学意义.结论 治疗较大年龄(＞10岁)儿童尺桡骨双骨折时,对于移位不明显的闭合性骨折,可应用TEN内固定;而对于移位较明显的开放性粉碎性骨折,采用钢板内固定能降低骨折畸形愈合的发生率.

abstractsObjective To compare the effect of titanium elastic nailing (TEN) and plating in treatment of both radius and ulna fractures in children older than 10 years.Methods This retrospective analysis comprised 38 children (50 sides) of both radius and ulna fractures treated with TEN (30sides) or plate (20 sides) between 2009 and 2014.Parameters compared between the two fixation methods were operation time,ratio of open/close reduction,time to internal fixation removal,incidence of postoperative complications,and bone union time.Anderson score was used to evaluate the treatment results.Results Operation time [(94.3 ± 39.5) min vs (120.5 ± 45.4) min],time to internal fixation removal [(210.8 ± 84.1) d vs (264.4 ± 88.9) d],and ratio of open/close reduction (20/10 vs 20/0)varied significantly between TEN and plating groups (P ＜ 0.05 or 0.01).Whereas,no statistically significant differences were noted in regard to complication rate,bone union time,and effect evaluation.Conclusion For fracture of the radius and ulna in children older than 10 years,TEN should be used for closed type without obvious displacement,but plate fixation is associated with lower incidence of fracture malunion and better outcome in treatment of open type with obvious displacement.