彈性骨髓內釘治療兒童前臂移位性骨幹骨折

Elastic Intramedullary Nailing for the Treatment of Displaced Diaphyseal Forearm Fractures in Children

目的：對於治療兒童前臂移位性骨幹骨折，有ㄧ些方法曾經被使用。本前瞻性研究是使用彈性骨髓內釘治療並評估其治療效果。方法：50 位兒童前臂移位性骨幹骨折使用彈性骨髓內釘治療，使用的適應症包括移位性閉鎖性或第一型開放性橈骨及尺骨骨幹骨折。結果：骨折平均的癒合時間為8 週（6-10 週），最後追蹤所有的病人都可以恢復到未受傷時的狀態。所有的骨髓內釘於骨折癒合後均已拔除，沒有病人發生不癒合、癒合不良及其他較嚴重的合併症。結論：使用彈性骨髓內釘治療只需要小的切口便可得到穩定的固定，相對於鋼板治療，使用彈性骨髓內釘有較美觀的傷口。因此我們建議對於骨骼尚未成熟的兒童前臂移位性骨幹骨折，使用彈性骨髓內釘治療是最好的選擇。

Background and purpose: Various techniques have been reported for the treatment of displaced and unstable diaphyseal forearm fractures in children. This prospective study was conducted to evaluate the results of intramedullary nailing using titanium elastic nails (TENs) for the treatment of pediatric forearm fractures. Methods: Fifty patients with displaced forearm fractures were treated with TENs. The indications for surgery included displaced closed fracture of radius and ulna, and displaced open type I fractures. Results: The mean time to union was 8 weeks (range, 6-10 weeks). At the time of the last follow-up, all of the patients had returned to their pre-injury activity level. The nails were removed in all patients after the fractures healed. There were no cases of nonunion, malunion, or other major complications. Conclusions: Intramedullary nailing with TENs allows a minimal incision, stable fixation, and a better cosmetic outcome than plating. We recommend that it should be as the treatment of choice for displaced diaphyseal forearm fractures in skeletally immature children.