锁定钢板与逆行交锁髓内钉治疗股骨远端A型骨折的临床观察  

Clinical Observation of Locking Plate and Retrograde Interlocking Intramedullary Nail in the Treatment of Type A Fracture of Distal Femur

作　　者：张海祥 曹阳 Zhang Haixiang;Cao Yang(Department of Bone Traumatology,the Frist Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院骨创伤科,辽宁锦州121000

出　　处：《锦州医科大学学报》2022年第1期30-34,共5页Journal of Jinzhou Medical University

基　　金：国家自然科学基金项目,项目编号:81471853。

摘　　要：目的评析股骨远端A型骨折应用锁定钢板与逆行交锁髓内钉的临床疗效。方法回顾性分析2016年9月至2018年3月收治的股骨远端骨折并给予手术治疗的患者,从中选出符合要求的46例患者,分为两组:骨折切开复位锁定钢板内固定(PL组)和骨折闭合复位逆行交锁髓内钉内固定(GSH组),每组23例。观察指标:手术切口长度、术中出血量、手术时间、术中透视次数、术后并发症、骨折临床愈合时间、膝关节功能康复疗效-Kolmert评分标准评定。结果在手术切口长度、术中出血量、手术时间方面,GSH组明显优于PL组(P<0.05),而PL组术中透视次数明显少于GSH组(P<0.05);两组术后并发症比较无统计学差异(P>0.05),GSH组比LP组骨折临床愈合时间较早,在膝关节功能康复疗效方面,两组在术后14天时,GSH组优于PL组,术后3个月时,结果无统计学意义(P>0.05)。结论逆行交锁髓内钉(GSH组)较锁定钢板(PL组)更有利于骨折愈合,更有利于膝关节的早期功能锻炼。Objective To evaluate and analyze the clinical effect of locking plates and retrograde interlocking intramedullary nails in treating type A fracture of distal femur.Methods The patients with distal femoral fractures treated by surgery from September 2016 to March 2018 were retrospectively analyzed.46 patients who met the requirements were selected and divided into two groups:fracture open reduction and internal fixation with locking plate(PL group)and fracture close reduction and internal fixation with retrograde interlocking intramedullary nail(GSH group),with 23 cases in each group.Observation Indexes:surgical incision length,intraoperative bleeding,operation time,intraoperative fluoroscopy times,postoperative complications,clinical healing time and rehabilitation effect of knee function evaluated by Kolmert score standard.Results In terms of surgical incision length,intraoperative bleeding and operation time,GSH group was significantly better than PL group(P<0.05),with more times of intraoperative fluoroscopy in PL group than that in GSH group(P<0.05).There was no significant difference in postoperative complications between the two groups(P>0.05).The GSH group had earlier clinical healing time than LP group.In terms of knee function rehabilitation effect,GSH group was better than PL group 14 days after operation,and the results were not statistically significant 3 months after operation(P>0.05).Conclusion Retrograde interlocking intramedullary nail(GSH group)is more conductive to fracture healing and early functional exercise of knee joint than locking plate(PL group).

关 键 词：股骨远端骨折 逆行髓内钉 锁定钢板 

分 类 号：R68[医药卫生—骨科学]