骨水泥柱髓内支撑结合锁定钢板固定治疗股骨远端粉碎性骨折  

Treatment of comminuted distal femoral fractures with bone cement column intramedullary support and locking plate fixation

作　　者：赵勇 周大鹏 乔跃跃 解冰 薛海鹏 ZHAO Yong;ZHOU Da-peng;QIAO Yue-yue;XIE Bing;XUE Hai-peng(Dept of Orthopaedics,the General Hospital of Northern Theater Command of CPLA,Shenyang,Liaoning 110016,China)

机构地区：[1]中国人民解放军北部战区总医院骨科,辽宁沈阳110016

出　　处：《临床骨科杂志》2023年第3期417-420,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨骨水泥柱髓内支撑结合锁定钢板固定治疗股骨远端粉碎性骨折的疗效。方法采用骨水泥柱髓内支撑结合锁定钢板固定治疗13例股骨远端粉碎性骨折患者。记录并发症发生情况、骨折愈合情况,采用Merchan评分评价膝关节功能。结果1例因过早负重发生钢板断裂(相关指标均不予考察);12例获得随访,时间13~28个月。切口均一期愈合,无术后感染、骨不连、肢体短缩及膝内外翻畸形等并发症发生。术后X线片显示:9例骨折对位对线良好、关节面平整,达解剖复位;2例存在轻度对位不良;1例股骨髁向后轻度成角。术后3个月X线片显示:12例骨折端可见骨痂生长。骨折均愈合,时间4.5~10.0个月。末次随访时采用Merchan评分评价膝关节功能:优6例,良3例,可2例,差1例,优良率9/12。结论骨水泥柱髓内支撑结合锁定钢板治疗股骨远端粉碎性骨折,不仅有助于维持骨折复位,而且能增加固定强度、更利于患者膝关节功能恢复,临床疗效满意。Objective To investigate the effect of bone cement column intramedullary support combined with locking plate fixation in the treatment of comminuted distal femoral fractures.Methods The 13 patients with comminuted distal femoral fractures were treated with bone cement column intramedullary support and locking plate fixation.The occurrence of complications and fracture healing were recorded,and the function of knee joint was evaluated with Merchan score.Results The 12 cases were followed up for 13~28 months,except 1 case of plate fracture due to premature loading(the related indicators were not calculated).The incisions healed in one stage without postoperative infection,bone nonunion,limb shortening and knee angulation deformity.Postoperative X-ray imaging showed that 9 cases had good alignment,and the articular surface was flat,reaching anatomical reduction;mild malalignment was found in 2 cases;the femoral condyle angulated slightly backward in 1 case.X-ray image of 3 months postoperative showed callus growth in 12 cases of fracture ends.All fractures healed within 4.5~10.0 months.At the last follow-up,the function of knee joint was evaluated with Merchan score:excellent in 6 cases,good in 3,fair in 2,and poor in 1.The excellent and good rate was 9/12.Conclusions The treatment of comminuted distal femoral fractures with bone cement column intramedullary support and locking plate is not only helpful for fracture reduction,but also can increase the fixation strength,which is conducive to the recovery of knee joint function.The clinical effect is satisfactory.

关 键 词：股骨远端骨折 骨水泥 锁定钢板 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]