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目的探讨Pavlik挽具有限制动治疗新生儿股骨干骨折的临床疗效。方法 2005年1月-2010年1月,应用Pavlik挽具有限制动治疗新生儿股骨干骨折47例。其中男26例,女21例;左侧16例,右侧31例。臀产位13例,剖宫产29例,正常分娩5例。治疗时年龄12 h～23 d。骨折发生于股骨干中上1/3段38例,中1/3段骨折9例;斜形或螺旋形33例,横行骨折14例。大腿外观有明显向外成角及重叠缩短畸形。成角移位平均45°(22°～80°),短缩移位平均1.0 cm(0.5～2.0 cm)。患儿下肢足趾血运好,无其他合并伤。治疗采用Pavlik挽具,双膝屈曲、双侧髋屈曲外展有限制动。定期随访复查X线片及适时调整挽具。结果 Pavlik挽具应用最短3周,最长6周,平均4周。X线片示骨折线模糊,连续性骨痂形成后去除Pavlik挽具,并定期随访至学步期。平均随访20个月(8个月～4 a),47例骨折均一期治愈,患侧肢体外形好,无短缩,无跛行步态。结论 Pavlik挽具有限制动治疗新生儿股骨干骨折方便简捷、安全可靠、疗效好、并发症少,不需要住院或住院时间短。
Objective To investigate the curative effect of Pavlik harness limited mobilization on neonatal femoral shaft fracture. Methods From January 2005 to January 2010, 47 cases of newborn femoral shaft fractures were treated with Pavlik harness limited motion. There were 26 males and 21 females, 16 on the left and 31 on the right. Hip in 13 cases, cesarean section in 29 cases, 5 cases of normal delivery. Treatment of age 12 h ~ 23 d. Fractures occurred in the upper third of the femoral shaft in 38 cases, 9 cases of 1/3 fracture; oblique or spiral in 33 cases, transverse fractures in 14 cases. Thigh appearance is obviously outward angle and overlap to shorten the deformity. Angular shift average 45 ° (22 ° ~ 80 °), shortening the average displacement of 1.0 cm (0.5 ~ 2.0 cm). Pediatric lower limb toe blood supply is good, no other combined injury. Treatment with Pavlik harness, knee flexion, bilateral hip flexion outreach limited movement. Regular follow-up X-ray film and adjust the harness timely. Results Pavlik harness application for a minimum of 3 weeks, up to 6 weeks, an average of 4 weeks. X-ray showed the fracture line fuzzy, callus formation after the removal of Pavlik harness, and regular follow-up to the toddler. The patients were followed up for an average of 20 months (ranged from 8 months to 4 years). All the 47 fractures were cured in one phase. The affected limbs had good shape, no shortening and no lame gait. Conclusions Pavlik harness limited mobility for the treatment of neonatal femoral shaft fractures convenient, safe, reliable, good effect, less complications, no hospitalization or hospitalization time is short.