儿童四肢长骨骨折弹性髓内钉内固定术后骨折延迟愈合的原因及治疗探讨.

Objective To explore the causes and outcomes of delayed fracture union after elastic stable intramedullary nailing (ESIN) for pediatric long bone fractures of extremities to minimize the occurrence of this complication and provide clinical rationales for managing delayed fracture union. Methods From July 2015 to April 2020, clinical data were retrospectively reviewed for 233 children with long bone fractures of extremities after ESIN.Nine cases of delayed fracture union were found during follow-ups.Age, injury mechanism, fracture site, surgical approach, post-discharge management and subsequent rehabilitation were recorded.For various causes of delayed fracture union, the corresponding treatment was offered. Results Two cases of delayed fracture union of double fracture of radius and ulna healed after prolonged plaster fixation and immobilization.Two cases of delayed tibial fracture union received proper weight bearing under brace protection.One case of delayed fracture union of femoral fracture healed after external fixation of hip with heriform plaster and removal of elastic intramedullary nail.One case of delayed fracture union of tibia (n=1), humerus (n=1) and femur (n=1) healed after anti-infection and immobilization of affected limb.One case of delayed tibial union underwent autologous bone grafting and plaster fixation. Conclusion Treatments of delayed bone union vary for different and different types of fractures.In this cohort, strengthened fixation, greater stress stimulation at broken end, anti-infection, bone graft reconstruction and other means have been adopted for attaining bone union.Removing the influencing factors of delayed healing and re-stabilizing fracture end are vital for successful treatments. [ABSTRACT FROM AUTHOR]