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目的总结47例产伤所致新生儿股骨骨折的诊治体会。方法1971～1998年间产伤所致新生儿股骨骨折47例,男24例,女23例;剖宫产39例,产道分娩18例;均为不稳定性骨折,斜形30例,横形17例;全部采用保守方法治疗。结果临床骨折愈合情况:平均成角39.25°(15°～80°),平均短缩0.69cm(0.5～1.5cm)。47例中29例获得随访,平均随访时间58个月(12～168个月)。25例肢体等长,4例患肢较健侧长1cm。走路无跛行,患肢功能恢复满意,髋、膝关节活动正常,骨折坚强愈合。结论新生儿股骨骨折是产伤所致长管状骨骨折中最常见的,畸形严重,保守治疗很难达到解剖复位,但其生长发育旺盛,骨折愈合快,自我矫形和塑形能力极强。治疗应以简单易行、损伤小、痛苦小、减少并发症为原则的保守治疗方法为佳。治疗标准应将公认儿童股骨骨折短缩在1～2cm内,成角小于25°,旋转小于15°的标准放宽,不主张为追求解剖复位而采取反复多次复位或切开复位的方法。
Objective To summarize the diagnosis and treatment of 47 cases of neonatal femoral fractures caused by birth trauma. Methods 47 cases of neonatal femoral fractures caused by birth trauma from 1971 to 1998, 24 males and 23 females; cesarean section in 39 cases, birth canal delivery in 18 cases; all unstable fractures, oblique in 30 cases, transverse in 17 cases All are treated conservatively. Results Clinical fracture healing: the average angle of 39.25 ° (15 ° ~ 80 °), the average shortening of 0.69cm (0.5 ~ 1.5cm). Twenty-nine of 47 patients were followed up for an average of 58 months (range, 12 to 168 months). 25 cases of limbs as long, 4 limbs than healthy side length 1cm. Walk without clashes, limb functional recovery satisfaction, hip, knee activity is normal, strong fracture healing. Conclusion Neonatal femoral fracture is the most common long bone fracture caused by birth trauma. The deformity is serious. Conservative treatment is very difficult to achieve anatomic reduction. However, its growth and development are rapid, fracture healing is rapid, and self-correction and shaping ability are extremely strong. Treatment should be simple, less injury, less pain, reduce complications as the principle of conservative treatment is better. Treatment criteria should be recognized shortening of femoral fractures in children within 1 ~ 2cm, angulation is less than 25 °, rotation less than 15 ° standard relaxation, do not advocate the pursuit of anatomical reduction to take repeated multiple resets or open reduction method.