AO微创内固定系统在股骨远端及胫骨近端粉碎性骨折的应用  

TREATMENT OF COMMINUTED FRACTURES AT DISTAL FEMUR AND PROXIMAL TIBIA WITH LESS INVASIVE STABILIZATION SYSTEMS

作　　者：熊建义[1] 王大平[1] 肖建德[1] 刘黎军[1] 张洪[1] 胡波[1] 刘建全[1] 

机构地区：[1]深圳市第二人民医院骨三科,广东深圳518035

出　　处：《中国修复重建外科杂志》2006年第7期702-705,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 探讨应用AO微创内固定系统（less invasive stabilization systems，LISS）治疗下肢股骨远端与胫骨近端粉碎性骨折的临床效果。方法 回顾性分析2003年9月～2005年5月采用LISS治疗14例下肢骨折患者，其中男13例，女1例；车祸伤9例，坠落伤3例，摔倒跌伤2例。开放性骨折5例，闭合性骨折9例。骨折部位包括股骨髁上及髁间粉碎性骨折5例，胫骨上段粉碎性骨折9例。骨折按照AO／OTA分类：股骨骨折中，33C2型3例，33C3型2例；胫骨骨折中，41A2型2例，41A3型2例，4182型3例，41C2型2例。分别应用股骨远端或胫骨近端LISS行内固定手术。术后对其伤口愈合、术前及术后X线片检查及关节功能恢复情况进行观察。结果 患者术后切口均Ⅰ期愈合。均获随访1～20个月，平均11个月。12例骨折均在术后3～5个月愈合，另2例经术后2～3个月观察，效果良好。关节功能根据Johner—Wruhs关节功能评定标准：优10例，良3例，可1例；优良率为93％。11例膝关节屈伸范围达110～130°，2例为100°，1例为80°。结论 LISS对股骨远端或胫骨近端粉碎性骨折是一种有效的内固定方法，具有创伤小，固定可靠，临床效果良好等优点。Objective To study the clinical outcome of comminuted factures at distal femur and proximal tibia treated with AO less invasive stabilization systems （LISS）. Methods The clinical data of 14 cases of distal femoral fracture and proximal tibial fracture from September 2003 to May 2005 were analyzed retrospectively. The injury was caused by traffic accident in 9 cases, by fall in 3 cases and by slipping in 2 cases. Of 14 cases, there were 5 open fractures and 9 close fractures, including 5 cases of distal femoral comminuted fracture and 9 cases of proximal shaft comminuted fractures. According to AO/OTA classification, the fractures were classified as 33C2 in 3 cases,33C3 in 2 cases,41A2 in 2 cases,41A3 in 2 cases,41B2 in 3 cases and 41C2 in 2 cases. All patients were treated by the internal fixation with LISS-distal femur or with LISS-proximal tibia. Healing of wounds, the X-ray films before and after operations, and the recovery of joint function were observed. Results The patients were followed up from 1 month to 20 months （11 months on average）. Twelve cases achieved solid osseous unions from 3 months to 5 months postoperativly; 2 cases had a good reduction and recovered smoothly 2-3 months postoperatively. The results were excellent in 10 cases, good in 3 cases and fair in 1 case according to Johner-Wruhs knee scoring. The range of knee flexion-extension was 110-130° in 11 cases, 100° in 2 cases and 80° in 1 case. Conclusion LISS is an effective method of internal fixation for treating comminnted fracture of distal femur or proximal tibia. It has the advantages of less injury, satisfied reduction and reliable fixation.

关 键 词：股骨远端 胫骨近端 粉碎性骨折 微创内固定系统 

分 类 号：R687.3[医药卫生—骨科学]