锁定板微创技术治疗老年人股骨远端骨折的临床效果观察  

Clinical Observation on the Therapeutic Effect of Locking Plates with MIPO on the Elderly Patients with Distal Femoral Fractures

作　　者：焦志坚[1] 李超[1] 种阳[1] 李国军[1] 张世谦[1] 邵明[1] 

机构地区：[1]哈尔滨医科大学附属第一医院骨科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2015年第5期873-877,共5页Progress in Modern Biomedicine

摘　　要：目的：探讨锁定板MIPO技术治疗老年人股骨远端骨折的临床效果。方法：回顾性分析2009年1月-2012年12月运用锁定板MIPO技术治疗老年人股骨远端骨折患者的临床资料,评估骨折类型、骨折愈合时间、6个月时的膝关节活动度和膝关节功能评分及临床并发症的发生情况。结果：共纳入33例老年人股骨远端骨折患者,平均年龄72岁,其中2例随访失败。87%的股骨远端骨折是关节外骨折;骨折平均愈合时间为12.56（8~29）周;术后6个月时平均活动范围超过105°：伸0°~30°,屈90°~140°;术后6个月的平均膝功能评分89.5;治疗过程中无植入失败、骨折不愈合和感染发生;术后早期发生下肢深静脉血栓（DVT）7例（22.6%）,均在膝关节水平以下。结论：锁定板结合MIPO技术是一种治疗老年人股骨远端骨折安全有效的方法,但要注意预防术后DVT的发生。Objective： To evaluate the clinical therapeutic effect of locking plates combined with MIPO technique on the elderly patients with distal femur fractures. Methods： From January 2009 to December 2012, a total of 33 elderly patients （average age 72 years） with distal femur fractures treated by the MIPO technique were reviewed retrospectively. The parameters including classification of frac- tures, time to fracture union, knee range of motion, knee functional scores （refered to AKS score standard） on 6 months, and other appar- ent complications were analyzed. Two patients were lost to in the follow-up visit. Results： 87% of the fractures were extra articular. The average time to union was 12.56 （range： 8-29） weeks. The average range of knee motion achieved at 6 months and beyond was 105° ranging from 0 to 30° （extension） to 90 to 140° （flexion）. Functional knee scores at 6 months from fixation were satisfactory （average score 89.5）. There was no case of implant failure, nonunion, infection as well. There were 7 （22.6%） patients developing deep vein thrombosis （DVT） in the early postoperative period, all of which were below the level of the knee joint. Conclusion： Locking plates com- bined with MIPO techniques was effective and safe in the treatment of the elderly patients with distal femur fractures, but the post opera- tive DVT should receive close attention at the same time.

关 键 词：股骨远端骨折 锁定板 微创术 老年人 内固定 

分 类 号：R683.42[医药卫生—骨科学]