三种内固定系统固定股骨远端骨折的疗效分析  

Three Internal Fixations for Distal Femoral Fracture

作　　者：刘发平[1] 王文春[2] 周敏[1] 方丹[1] 廖春来[1] 苏琦[1] 

机构地区：[1]解放军188医院创伤骨科,广东潮州521000 [2]成都军区总医院康复医学科

出　　处：《西南军医》2012年第3期399-402,共4页Journal of Military Surgeon in Southwest China

摘　　要：目的分析股骨远端骨折的三种内固定系统的临床疗效及适应证。方法手术治疗股骨远端骨折62例,分别采用锁定钢板(LCP)、髁支持钢板、逆行髓内钉内固定治疗,术后随访比较分析三组患者的治疗效果。结果三组患者术后均得随访,随访时间8～22月(平均10±4.2月);按Merchan评分标准评定术后功能恢复情况;三组患者的手术时间、骨折愈合时间、恢复工作时间、并发症比较,差异均无统计学意义(P>0.05);但逆行髓内钉组的术中出血量明显少于其它两组,差异有统计学意义(P<0.05);LCP组的术后优良率优于其它两组,差异具有统计意义(P<0.05)。结论三种内固定系统用于股骨远端骨折的治疗,均能取得良好疗效。但是,LCP是骨质疏松性骨折、C型骨折的最佳选择;髁支持钢板适合于骨质条件好、低能量创伤所致的A型与B型、C1、C2型骨折;逆行髓内钉主要用于A型骨折。Objective To analyze the clinical effects of 3 internal fixations for distal femoral fracture. Methods Locking compression plate fixatlon,retrograde intramedullary nail fixation and compressed plate fixation were adopted respectively in treating distal femoral fracture in 62 patients. The clinical effects were compared in the 3 groups. Results The survey of the results of surgery was followed up for 8 - 22 months with a mean of 11 months in all patients. The postoperative recovery of function was rated according to the Merchan score system. The operating time,fracture healing time,patient＇s work resuming time and incidence of complications showed no significant difference between the 3 groups（P 〉0. 05） . But the amount of intmoperative bleeaing was evidently smaller in the retrograde intramed,llary nail fixation group than in the other 2 groups, which showed a significant difference（P 〈 0. 05 ）. The excellent postoperative f^mctionsl recovery rate was higher in the locking campression plate fixation group than in the other 2 groups,which showed a significant difference（P 〈0. 05）. Conclusions The 3 internal fixations for distal remain1 fracture can effect a good cure. But locking compression plate fixation is the best choice for osteopo- rotic fracture and type- C fracture, compressed plate fixation is suitable to type- A, type- B ,type- C1 and type -C2 fractures due to low energy trauma,and retrograde intramedullary nail fixation applies mainly in the treatment of type- A fracture.

关 键 词：股骨远端骨折 内固定 锁定钢板 逆行髓内钉 髁支持钢板 

分 类 号：R683.42[医药卫生—骨科学]