双切口锁定钢板联合重建钢板内固定治疗股骨远端C2、C3型骨折的临床疗效  

Clinical Effect of Double Incision Locking Plate Combined with Reconstruction Plate Internal Fixation in Treatment of Distal Femoral Type C2 and C3 Fractures

作　　者：蒲敏[1] 蒋演 PU Min;JIANG Yan(Department of Orthopedics,Ya′an People′s Hospital,Ya′an 625000,China;Department of Orthopedics,Neijiang Hospital of Traditional Chinese Medicine,Neijiang 641000,China)

机构地区：[1]雅安市人民医院骨科,四川雅安625000 [2]内江市中医医院骨科,四川内江641000

出　　处：《医学综述》2022年第17期3505-3510,共6页Medical Recapitulate

基　　金：四川省卫生和计划生育委员会科研课题(17PJ210)。

摘　　要：目的探讨双切口锁定钢板联合重建钢板内固定治疗股骨远端C2、C3型骨折的临床疗效。方法选取2019年1月至2021年1月雅安市人民医院骨科收治的56例和内江市中医医院骨科收治的23例共79例股骨远端C2、C3型骨折患者为研究对象,按照手术方法不同分为对照组(42例)和研究组(37例)。对照组采用双切口锁定钢板内固定治疗,研究组采用双切口锁定钢板联合重建钢板内固定治疗。比较两组患者手术相关指标(术中出血量、手术时间、术中C型臂透视次数、术后引流量、术后下床活动时间、住院时间、骨折愈合时间),术后3个月恢复情况[膝关节活动度、视觉模拟评分法(VAS)评分、美国特种外科医院膝关节评分(HSS)],临床疗效以及术后并发症发生情况。结果研究组患者术中出血量大于对照组[(287±30)ml比(241±27)ml],手术时间长于对照组[(116±13)min比(103±12)min],术后下床活动时间及骨折愈合时间均短于对照组[(26±3)d比(30±4)d,(4.4±1.0)个月比(4.8±1.1)个月](P<0.05或P<0.01)。膝关节活动度、VAS评分、HSS评分组间和时点间的主效应差异有统计学意义(P<0.01),组间和时间点均存在交互作用(P<0.01),术后3个月,两组患者膝关节活动度及HSS评分均升高,且研究组高于对照组(P<0.05);术后3个月,两组患者VAS评分均降低,且研究组低于对照组(P<0.05)。研究组患者优良率高于对照组[86.49%(32/37)比66.67%(28/42)](P<0.05)。两组患者术后并发症发生率比较差异无统计学意义(P>0.05)。结论双切口锁定钢板联合重建钢板内固定治疗股骨远端C2、C3型虽术中出血量较多、手术时间较长,但总体效果优于双切口锁定钢板内固定术,可在一定程度上缩短术后下床活动时间和骨折愈合时间,减轻患者疼痛,恢复膝关节功能,且不会增加术后并发症发生率。Objective To investigate the clinical efficacy of double incision locking plate combined with reconstruction plate internal fixation in the treatment of type C2 and C3 fractures of the distal femur.Methods A total of 56 patients with C2 and C3 fractures of the distal femur admitted to the Department of Orthopedics of Ya′an People′s Hospital and 23 patients admitted to the Department of Orthopedics of Neijiang Traditional Chinese Medicine Hospital,altogether 79 patients,from Jan.2019 to Jan.2021 were included in the study,and they were divided into a control group(42 cases)and a study group(37 cases)according to different surgical methods.The control group was treated with double incision locking plate internal fixation,and the study group was treated with double incision locking plate internal fixation combined with reconstruction plate internal fixation.The surgery-related indexes(intraoperative bleeding,operation time,number of intraoperative C-arm fluoroscopy,postoperative drainage,postoperative bed activity time,hospitalization time,fracture healing time),recovery at 3 months after surgery[knee mobility,pain visual analog scale(VAS)score,hospital for special surgery(HSS)knee score],clinical efficacy and postoperative complications of the two groups were compared.Results The amount of intraoperative blood loss and operation time in the study group were greater than those in the control group[(287±30)ml vs(241±27)ml,(116±13)min vs(103±12)min],the postoperative ambulation time and fracture healing time were shorter than the control group[(26±3)d vs(30±4)d,(4.4±1.0)months vs(4.8±1.1)months](P<0.05 or P<0.01).There were statistically significant differences in the main effects of knee mobility,VAS score,and HSS score between groups and time points(P<0.01),and there were interactions between groups and time points(P<0.01).At 3 months after surgery,the knee mobility and HSS scores increased in both groups,and the study group was higher than the control group(P<0.05);at 3 months after surgery,the VAS scor

关 键 词：股骨骨折 双切口锁定钢板内固定术 重建钢板内固定术 膝关节功能评分量表 

分 类 号：R683.42[医药卫生—骨科学]