外侧解剖型锁定钢板辅助骨折复位治疗股骨远端C3型骨折的临床效果  

Clinical effect of lateral anatomical locking plate assisted fracture reduction in the treatment of distal femoral C3 fracture

作　　者：刘林 阿良[1] 吴宪达 宋佳 胡丹丹 刘晓娜[4] 姜向春[4] LIU Lin;A Liang;WU Xianda;SONG Jia;HU Dandan;LIU Xiaona;JIANG Xiangchun(Department of Orthopaedics,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,China;Department of Obstetrics and Gynecology,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,China;Department of Radiology,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,China;Department of Paediatrics,Chinese PLA 32183 Hospital)

机构地区：[1]沈阳医学院附属中心医院骨外科,辽宁沈阳110024 [2]沈阳医学院附属中心医院妇产科,辽宁沈阳110024 [3]沈阳医学院附属中心医院放射科,辽宁沈阳110024 [4]中国人民解放军第32183医院儿科

出　　处：《沈阳医学院学报》2019年第6期518-521,共4页Journal of Shenyang Medical College

摘　　要：目的:探讨利用股骨远端解剖型锁定钢板辅助C3型骨折复位的手术方式,通过相应的指标进行评价,来了解此手术方法的临床效果。方法:回顾性分析2016年1月至2017年12月使用股骨远端解剖型锁定钢板辅助骨折复位治疗C3型骨折10例的临床资料。结果:患者平均年龄(53.80±12.64)岁,7例患者为女性。车祸6例,自行摔伤2例,从高处坠落2例。骨折术后X线胫股解剖角平均为(175.45±2.26)°;股骨远端外侧解剖角(83.56±1.63)°;股骨髁干角(94.46±3.48)°。术后平均愈合时间为(27.2±10.2)周,2例患者出现延迟愈合,其余患者愈合良好。2例患者术后出现软组织的浅表感染,1例患者出现创伤性膝关节炎。术后12个月的HSS评分平均为(78.80±13.2)分。根据Schatzker和Lambert提出的标准,7例患者优异,3例患者良好。结论:此手术方式能够有效地纠正股骨远端骨折冠状面的短缩、旋转及内外翻移位,矢状面的远端向后移位、成角畸形;同时对即使有单侧皮质完好的髁部严重粉碎骨折也能起到固定作用,稳定的内固定方式降低了骨折不愈合与畸形愈合的风险,从而让患者早期进行膝关节的功能锻炼、改善预后。Objective: To investigate the clinical effects of lateral anatomical locking plate assisted fracture reduction in the treatment of distal femoral C3 fracture. Method: The clinical data of 10 patients with distal femoral C3 fractures treated with anatomical locking plate assisted reduction from Jan 2016 to Dec 2017 were retrospectively analyzed. Results: The average age of the patients was(53.80±12.64) years old, and 7 patients were women. There were 6 cases of car accidents, 2 cases of self-injury, and 2 cases of falling from high places. After treatment, the mean tibiofemoral angle was(175.45±2.26)°, the lateral anatomical angle of the distal femur was(83.56±1.63)°, and the femoral condyle shaft angle was(94.46±3.48)°. The average postoperative healing time was(27.2±10.2) weeks. Two patients had delayed union and the other patients healed well. Two patients developed superficial soft tissue infections and one patient developed traumatic knee arthritis. The average HSS score at 12 months after surgery was(78.80 ± 13.2).According to the criteria of Schatzker-Lambert, 7 patients were excellent and 3 patients were good. Conclusions: Application of lateral anatomical locking plate assisted fracture reduction in the treatment of distal femoral C3 fracture can effectively correct the shortening, rotation, internal/external displacement, the displacement in the distal end of the sagittal plane, and the angular deformity.This surgical procedure can also fix the severely comminuted fracture of the ankle with intact unilateral cortex. The stable internal fixation reduces the risk of fracture nonunion and malunion, allowing patients to perform functional exercise early and improve prognosis.

关 键 词：股骨远端C3型骨折 外侧解剖型锁定钢板 复位方式 

分 类 号：R684.3[医药卫生—骨科学]