单侧与双侧钢板治疗粉碎性股骨远端骨折的疗效比较  

Comparative study of unilateral and bilateral plate in fixation of comminuted distal femoral fractures

作　　者：张俊[1] 邱永敏[1] 尹伟忠[1] 丁菊红[1] 沈燕国[1] 曹师锋[1] Zhang Jun Oiu Yongmin Yin Weizhong et al(Department of Orthopaedics, Shanghai Pudong New Area People＇s Hospital, Shanghai, 201299, China)

机构地区：[1]上海市浦东新区人民医院骨科,上海201299

出　　处：《生物骨科材料与临床研究》2017年第1期56-60,共5页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2015-14)

摘　　要：目的比较单侧钢板(锁定钢板)与双侧钢板(锁定钢板+重建钢板)治疗粉碎性股骨远端骨折的疗效。方法回顾性分析2008年6月~2015年5月治疗且获随访的72例粉碎性股骨远端骨折,其中32例患者采用单钢板治疗,40例患者采用双钢板治疗,随访12~36个月,平均19.8个月,比较两组患者手术时间、术中出血量、切开手术/微创手术、植骨/未植骨、骨折愈合时间、术后并发症、末次随访时膝关节活动度和功能评分。结果单钢板组与双钢板组手术时间比较差异有统计学意义(<0.05)。切开手术组与微创手术组术中出血量、骨折愈合时间、膝关节活动度比较差异有统计学意义(<0.05)。植骨组与未植骨组骨折愈合时间比较差异有统计学意义(<0.05)。结论单、双侧钢板内固定治疗粉碎性股骨远端骨折均能取得较好疗效,但单钢板治疗手术时间短,有更好的成本效益比,结合微创技术、必要时植骨,可以获得更佳的治疗结果。Objective To compare the efficacy of unilateral plate （locking plate） and bilateral plates （locking plate combined with reconstructive plate） for the treatment of eomminuted distal femoral fractures. Methods Seventy-two cases of comminuted distal femoral fractures from Jun 2008 to May 2015 were divided into two groups, of which 32 patients were treated with unilateral plate and 40 cases with bilateral plates, followed up for 12 to 36 months, with an average of 19.8 months. A retrospective study was performed to compare the outcomes of two methods pertaining to operation time, intraoperative blood loss, open surgery/mini-invasive surgery, bone graft/without bone graft, fracture union time, postoperative complications, range of motion, and knee function evaluation score at last follow-up. Results The operation time was significantly shorter in the unilateral plate group （P〈0.05）. There were significant differences between open surgery and mini-invasive surgery regarding intraoperative blood loss, fracture union time, range of motion at last follow-up （P〈0.05）. The fracture union time was significantly shorter in the bone graft group （P〈0.05）. Conclusion Treatment of comminuted distal femoral fractures with unilateral and bilateral plate can achieve good functional recovery, but unilateral plate has the advantages of shorter operation time and preferable cost-effective ratio, achieving better results with mini-invasive surgery and bone graft if needed.

关 键 词：股骨远端骨折 锁定钢板 微创 内固定 

分 类 号：R687.32[医药卫生—骨科学]