Displaced Tibial Shaft Fractures With Intact Fibula in Children: Nonoperative Management Versus Operative Treatment With Elastic Stable Intramedullary Nailing
Displaced Tibial Shaft Fractures With Intact Fibula in Children: Nonoperative Management Versus Operative Treatment With Elastic Stable Intramedullary Nailing
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DOI：
10.1097/bpo.0000000000000528
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发表时间：
2016-10-01
影响因子：
1.7
通讯作者：
Rousset, Marie
中科院分区：
文献类型：
--
作者：
Canavese, Federico;Botnari, Alexei;Rousset, Marie
背景：本研究的主要目的是回顾性评价儿童胫骨干骨折伴腓骨完整的非手术治疗和弹性髓内钉手术治疗后的临床和影像学结果。方法：对来自2个机构的80例儿童进行了研究，男56例，女24例，胫骨干骨折伴腓骨完整的闭合性移位骨折。所有患者进行定期临床和影像学随访至少2年后injure.Results：在总数，26例（A组机构I）进行了手术治疗的弹性稳定髓内钉和54例（B组机构I和C组机构II的18例和36例）进行了非手术治疗的闭合复位和铸造。A、B和C组在性别上没有显著差异（P=0.37），侧外翻畸形仅A组患者（P =0.001）、B组患者（P = 0.017）在随访期间得到显著控制，C组患者治疗前图像与末次随访之间无显著变化（P = 0.71）。仅A组患者的前曲畸形得到显著控制（P=0.001），B组（P=0.73）和C组患者（P=0.8）保守治疗后前曲畸形无显著改善。A组术后复发情况明显改善（P
Background:The main objective of this study was to retrospectively evaluate the clinical and radiographic outcomes of displaced tibial shaft fractures with intact fibula in children after nonoperative management and operative treatment by elastic stable intramedullary nailing.Methods:A study was performed on 80 consecutive children, 56 males, 24 females from 2 Institutions, with displaced and closed tibial shaft fracture with intact fibula. All patients underwent regular clinical and radiographic follow-up visits for at least 2 years after injury.Results:In total, 26 patients (group A-Institution I) were treated surgically by elastic stable intramedullary nailing and 54 patients (18 patients from group B-Institution I and 36 patients from group C-Institution II) were treated nonoperatively with closed reduction and casting. groups A, B, and C did not significantly differ on sex (P=0.37), side (P=0.54), and fracture site (P=0.14).Valgus deformity was significantly controlled in group A patients only (P=0.001); during follow-up in group B patients (P=0.017), and showed no significant change between pretreatment images and last follow-up in group C patients (P=0.71). Procurvatum deformity was significantly controlled in group A patients only (P=0.001); it showed no significant improvement after conservative treatment in group B (P=0.73) and C patients (P=0.8). Recurvatum was significantly improved in group A (P