股骨髁间C型骨折不同手术内固定疗效体会  

An Comparison on The Experience Related to the Effect of Various Internal Fixation Methods on C-type Fracture of Femur

作　　者：陈自主 

机构地区：[1]广东省惠州市惠东县第二人民医院,惠州516351

出　　处：《数理医药学杂志》2015年第8期1115-1116,共2页Journal of Mathematical Medicine

摘　　要：目的：比较股骨髁间复杂C型骨折的不同内固定方式的疗效和适应证.方法：对2012年1月-2014年6月,分别采用3种内固定方法治疗成年股骨髁间C复杂骨折78例,其中钢板36例,逆行交锁髓内钉固定组28例,DCS14例,均获随访18-36个月,平均24个月,骨折平均愈合时间为15~20周.结果：对于股骨髁间C型的复杂类型骨折,采取3种不同内固定方法均能达到良好的疗效.但对比的结果显示,逆行交锁髓内钉系统手术及骨折愈合时间较短,锁定钢板系统能最大限度地减少软组织损伤,对膝关节功能的恢复要优于逆行交锁髓内钉系统,DCS手术及骨愈合时间相对长,并发症较多.结论：在股骨髁间C型骨折中,C1型首选GCS固定;C2型骨折尽量选用逆行交锁髓内钉固定,但若有内外髁骨折较重,即选用锁定钢板;C3型骨折中以锁定钢板为佳,合并有骨缺损一期值骨术.Objective:To compare the effect of various internal fixation methods on C-type fracture of fe-mur and the indications.Methods:Treat 78 adult patients with C-type fracture of femur during the period from January 2012 to June 2014 with 3 different internal fixation methods respectively,among them,36 cases were fixed with Plate,28 cases were fixed with intramedullary supracondylar nail and 14 cases were fixed with DCS,pay a follow-up to all of them for about 18 to 36 months,namely ,an average follow-up of 24 months,the average healing time of fracture was about 15 to 20 weeks.Results:In allusion to the complex C-type fracture of femur,to fix with 3 different fixation methods can all achieve fine effect,according to the re-sult compared,the healing time is shorter if fixing through intramedullary supracondylar nailing system and fixing plate system can reduce the harm to soft tissues to largest extent ,and the recovery of knee joint func-tion was better than that in intramedullary supracondylar nailing system ,the healing time was Relatively longer in DCS system and a lot of complications may occur.Conclusion:In allusion to C-type fracture of fe-mur,to fix with GCS is optimal for the C1 type,and as for the C2 type,if would be advisable to try to fix with intramedullary supracondylar nail,but if the external or internal condylar fracture is more serious,then plate may be the best choice,as for the C3-type fracture,locking plate is optimal.

关 键 词：股骨髁C型骨折 逆行交锁钉 锁定钢板 DCS 

分 类 号：R683.42[医药卫生—骨科学]