儿童股骨近端骨折早期锁定加压钢板失败

Seth R. Cope, Matthew Wideman, Benjamin W. Sheffer, J. Sawyer, J. Beaty, David D. Spence, D. Kelly
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引用次数: 0

摘要

背景:虽然股骨近端锁定加压钢板(PF-LCP)在儿童股骨近端骨折固定中的应用越来越频繁,但缺乏关于其应用的文献。本研究的目的是检查PF-LCP固定的失败率,与其他公认的固定方法在儿科人群中进行比较。方法:回顾性分析2008年9月至2019年2月连续治疗股骨近端骨折的儿童,随访时间至少为12周。回顾了患者图表和x光片,并汇编了人口统计信息。在发生故障的情况下,记录了故障发生的时间和方法。结果:对61例儿童股骨近端骨折64例进行了研究。发病时的平均年龄为10.4岁。26例骨折采用pf - lcp治疗,38例采用其他固定方法(髋加压螺钉、刚性锁定髓内钉、空心螺钉或髋侧钢板与髓内钉联合)。锁定加压钢板治疗26例骨折中有4例(15.4%)骨折失败,而其他固定方式治疗38例骨折均无失败(p<0.05)。结论:本研究表明,与0%的其他固定方法(无失败)相比,锁定加压钢板治疗股骨近端骨折失败的风险增加(12.9%)。由于这项研究,我们不再使用锁定钢板系统治疗小儿股骨颈骨折。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early Failure of Locking Compression Plates in Pediatric Proximal Femoral Fracture
Background: Although proximal femoral locking compression plates (PF-LCP) have been used with increasing frequency in the fixation of proximal femoral fractures in the pediatric population, there is a lack of literature regarding their use. The purpose of this study was to examine the failure rates of PF-LCP fixation in comparison to other accepted fixation methods within a pediatric population. Methods: Retrospective review identified consecutive children treated for proximal femoral fractures from September, 2008 to February, 2019, who had a minimum follow-up of 12 weeks. Patient charts and radiographs were reviewed, and demographic information was compiled. In the case of failures, timing and method of failure were documented. Results: Sixty-four proximal femoral fractures (61 children) were studied. The average age at the time of presentation was 10.4 years. Twenty-six fractures were treated with PF-LCPs and 38 with other fixation methods (compression hip screws, rigid locked intramedullary nailing, cannulated screws, or a combination of hip screw side plate and intramedullary nailing). Failure occurred in four of the 26 fractures treated with locking compression plating (15.4%), compared to none of the 38 treated with other fixation types (p<0.05). Conclusions: This study demonstrates an increased risk of failure in proximal femoral fractures treated with locking compression plates (12.9%) compared to 0% other fixation methods (no failures). As a result of this study, we no longer use locked plating systems for pediatric femoral neck fractures at our institution.
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