热带军训致股骨中下1/3完全性应力骨折三种治疗方法的疗效分析  

Analysis of Curative Effects of Three Treatment Methods on Complete Stress Fracture of Mid-distal Femur in Militray Training

作　　者：邓迎生[1] 许声联[1] 潘林奇[1] 林廷军[1] 云雄[1] 

机构地区：[1]解放军187医院,海口571159

出　　处：《华南国防医学杂志》2003年第1期7-9,共3页Military Medical Journal of South China

摘　　要：目的:探讨军训所致股骨中下1/3应力骨折的机理和临床特点,并分析三种治疗方法的疗效。方法 总结分析53例患者,切开复位95°L地型钢板内固定29例,加压钢板14例,胫骨结节牵引结合石膏外固定10例。结果:53例均骨性愈合,不同程度地恢复下肢负重及膝关节功能:按改良Kolmert标准评定,膝关节活动度的恢复,L型钢板组优于加压钢板组、加压钢板组优于牵引组。结论:(1)本病的发生与股骨解剖结构、肌群分布、军训后肌肉疲劳及应力集中等因素密切相关;(2)本病具有发病部位、时间较集中、骨折愈合较快、但易粘连、影响膝关节功能的特点;(3)L型钢板适应局部解剖特点、符合生物力学要求且材质坚硬,能达到解剖复位、坚强内固定和早期功能锻炼的要求,为本病首选。Objective To explore the mechanism and clinical features of the stress fracture of mid-distal femur produced by military training and to analyse the curative effects of the three treatment methods on it.Methods of 53 patients with stress fracture of mid-distal femur, 29 received internal fixation of the femoral fracture by the L-type steel plate and screws, 14 by the right pres-sor steel plate and screws,and 10 underwent the traction of tuberositas tibiae and plaster immobilization.Results The follow-up for 6-28 months showed that the fracture healing was satisfactory and the functional rehabilitation of the knee joints in different degrees was observed in the pacients.According to improved Kolmert's assessing method the functional rehabilitation of the knee joints in L-type steel plate group was significantly superior to that in the right pressor steel plate group (P <0.05), which was significantly better than that in the traction group (P <0.05).Conclusion (1)The fracture is related with the structure of femur and thigh muscles stress focus and the fatigue of musculus quadriceps femoris during military training. (2)The site and time of the fracture occurence are similar to each other in the patients with mid-dictal femur fracture in militray training.This fracture is of features such as faster healing,easier adhesion of the quadriceps and disturbance of function of the knee joints. (3 )The L-type seel plate internal fixation is firstly selected for the treating this fracture because it is conformable to the treatment principle of the fracture such as anatomical reduction, firm fixation and taking exercise early.

关 键 词：股骨 应力骨折 训练伤 治疗 

分 类 号：R873.5[医药卫生—运动医学]