Comparison of efficacy of closed reduction and the use of two or three elastic intramedullary nail internal fixation in treatment of femoral subtrochanteric fractures in children
Comparison of efficacy of closed reduction and the use of two or three elastic intramedullary nail internal fixation in treatment of femoral subtrochanteric fractures in children
Objective To compare the clinical efficacy of closed reduction and the use of two or three elastic intramedullary nails for the treatment of femoral subtrochanteric fractures in children.Methods Fifty-five children with femoral subtrochan-teric fractures were treated with closed reduction and elastic intramedullary nail fixation from January 2018 to January 2022 were included.Among them,28 cases in group A were fixed with two elastic intramedullary nails while 27 cases in group B were fixed with three elastic intramedullary nails.The surgical time,intraoperative blood loss,postoperative time to mobiliza-tion,postoperative fracture end angulation,fracture healing time,as well as hip joint range of motion in all directions,differ-ence in length between the two lower limbs,femoral neck shaft angle,and Flynn functional score at the last follow-up were compared between the two groups.Results All cases were followed up for 12-18 months,with an average of 15.4 months.All patients did not experience complications such as incision infection,intramedullary nail withdrawal,intramedullary nail frac-ture,or non-union of fractures.One case had fracture malunion(angle＞5°)in group A,but the angle＜10°at the last follow-up.One case had a shortened lower limb length of 1 cm on the affected side compared to the healthy side after surgery,and the length difference was within 2 cm at the last follow-up.Two cases of skin irritation occurred at the nail site in group B,and symptomatic treatment was given.The operation time of group B was longer than that of group A,and the intraoperative blood loss was greater than that of group A.However,the time to start mobilization after surgery and fracture healing time were shorter than those of group A,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the angle of fracture end,femoral neck shaft angle,and length discrepancy of both lower limbs between group A and group B af-ter surgery(P＞0.05).There was no statistically significant difference in hip joint range of motion and Flynn function assessment results between group A and group B at the last follow-up(P＞0.05).Conclusion Closed reduction and elastic intramedullary nail fixation is an effective surgical method for treating femoral subtrochanteric fractures in children.Compared with two elastic intramedullary nails fixation,three elastic intramedullary nails fixation can enable children to engage in weight-bearing activities earlier and have a shorter fracture healing time.
维普
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