股骨远端骨折3种内固定方法疗效评价  

Curative effect evaluation of three internal fixation methods for distal femoral fracture

作　　者：韩擎天[1] 汤红伟[1] 徐卫红[1] 

机构地区：[1]上海交通大学医学院附属仁济医院嘉定分院骨科,上海201800

出　　处：《临床骨科杂志》2011年第3期296-298,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨3种内固定方法治疗股骨远端骨折的临床疗效。方法对95例股骨远端骨折患者分别采用加压钢板(16例)、L形髁钢板(20例)、股骨髁上交锁髓内钉(59例)内固定。比较3组内固定的手术时间、术中出血量、术后引流量、骨折愈合时间。结果 95例均获随访,时间5个月~9年。手术时间:股骨交锁髓内钉组短于另两组(P<0.05、P<0.01);术中出血量和术后引流量:股骨交锁髓内钉组均少于另两组(P<0.01);骨折愈合时间:股骨交锁髓内钉组(5.2±0.5)个月,L形髁钢板组(9±0.6)个月,加压钢板组(11.3±0.6)个月,差异有统计学意义(P<0.01)。按Kolm ert功能评定标准,3组优良率分别为:股骨髁上交锁髓内钉组94.9%,L形髁钢板组80%,加压钢板组62.5%。结论采用股骨髁上交锁髓内钉固定方法疗效优于其他两种内固定方法,具有操作简单、出血少、创伤小、锁钉定位准确、固定牢靠、并发症少等优点,是治疗股骨远端骨折较好的内固定方法。Objective To investigate the effects of three internal fixation methods for the treatment of distal femoral fracture.Methods 95 cases of distal femoral fracture were treated with compressed plate,L-shaped condylar plate,supracondylar intramedullary interlocking.The operative time,operative blood loss,post operative drainage volume and the healing time of fracture of patients in three groups were observed and compared.Results 95 cases were followed up 5 months^9 years.The operative time： supracondylar intramedullary interlocking shorter than other group（P0.05,P0.01）.More lesser operative blood loss and post operative drainage volume（P0.01）.The average time of fracture bone healing in group supracondylar intramedullary interlocking,L shaped condylar plate and compressed plate was respectively（5.2±0.5） months,（9±0.6） months and（11.3±0.6） months.The evaluation of the results by Kolmert′s functional rating scale revealed good and excellent were 94.9% for supracondylar intramedullary interlocking nail,80% for L-shaped condylar plate,and 62.5% for compressed plate.Conclusions Supracondylar intramedullary interlocking nail method is the ideal method among different internal fixation methods.It has advantages of good screw location,solid fixation and less blood loss and trauma and complication.The patient could exercise early,which is very useful to avoid the traumatic osteoarthritis of the knee joint.It is a very good internal fixation method for distal femoral fracture.

关 键 词：股骨远端骨折 骨折固定术 内/方法 交锁髓内钉 疗效评价 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]