逆行可膨胀髓内钉与锁定钢板治疗股骨远端骨折的疗效比较  

Comparison of Retrograde Expandable Nail and Locking Plate Fixation for Distal Femoral Fractures

作　　者：李岩[1] 龙江[1] 范书勇 王陶然[1] 袁志[1] 

机构地区：[1]第四军医大学西京医院创伤骨科,陕西西安710032

出　　处：《现代生物医学进展》2017年第2期272-275,共4页Progress in Modern Biomedicine

基　　金：全军医学科技青年培育项目(13QNP130)

摘　　要：目的:探讨比较运用逆行可膨胀髓内钉与股骨远端锁定钢板治疗股骨远端33A、33C1型骨折的疗效。方法:对2013年3月至2015年6月收治并符合纳入标准的43例股骨远端33A、33C1型骨折患者进行回顾性研究。按照不同的手术固定方式分为逆行可膨胀髓内钉组(n=18)和锁定钢板组(n=25),记录并比较两组手术时间、失血量、愈合时间及功能结果、术中及术后并发症。结果:所有骨折最终都获得愈合;逆行可膨胀髓内钉组在手术时间及失血量上都显著低于锁定钢板组,两组在愈合时间及功能评定方面无明显差异;5例开放性骨折的患者中1例出现浅表伤口感染,1例患者延迟愈合。结论:股骨远端逆行可膨胀髓内钉在获得与锁定钢板相当的骨折愈合时间及患肢功能的情况下,具有操作简单、手术时间短、失血量少等特点,对于股骨远端33A、33C1型骨折来说是一个较好的选择。Objective： To compare the effectiveness of Retrograde Expandable Nail（REN） and locking plate（ LP） for the treatment of AO 33 A, 33C1 distal femoral fractures. Methods： We retrospectively analyzed 43 patients with distal femoral fractures from March 2013 to June 2015. 18 were fixated with REN and 25 with LP. The 2 groups were compared with respect to operation time,amount of estimated blood loss, healing time and HSS knee scores, and intra- and postoperative complications. Results： All the fractures eventually united retrograde Expandable Nail performed better than locked nailing in operation time, amount of estimated blood loss（P〈0.001）. There was no difference in fracture union time and HSS knee scores. One of the five patients with open fractures had superficial wound infections, delayed healing in one patient. Conclusion： This study demonstrate that the retrograde femoral expandable nail approach yields comparable fracture union time and extremity function outcome with locking plate fixation. While it allows for an easier management, shorter operating time and lesser estimated blood loss. Making the retrograde expandable femoral nail a reasonable alternative for treating distal femur types A and C1 fractures.

关 键 词：股骨远端骨折 逆行可膨胀髓内钉 锁定钢板 

分 类 号：R683.42[医药卫生—骨科学]