单一切口双钢板治疗股骨远端粉碎性骨折的疗效  

The clinical effect of single-incision double-plate fixation for distal femoral comminuted fractures

作　　者：孟亚强[1] 岳晓东[1] MENG Ya-qiang;YUE Xiao-dong(SectionⅢ,Dept of Orthopaedics,the People′s Hospital of Zunhua City,Zunhua,Hebei 064200,China)

机构地区：[1]遵化市人民医院骨三科,河北遵化064200

出　　处：《临床骨科杂志》2024年第1期97-101,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨单一切口双钢板治疗股骨远端粉碎性骨折的疗效。方法采用单一切口双钢板治疗30例股骨远端粉碎性骨折患者。记录骨折复位及愈合情况、负重行走情况、术后并发症发生情况、膝关节活动度,采用New KSS评分系统评价膝关节功能。结果患者均获得随访,时间6~24个月。术后均无感染、肢体短缩或旋转、关节半脱位等情况发生。术后X线片显示:28例骨折对位对线良好,关节面平整,达到解剖复位;2例轻度膝内翻。患者术后1~2周开始拄拐患肢不负重功能锻炼,术后4~6个月逐渐弃拐负重行走。除1例因过早负重术后12个月骨折延期愈合外,其余患者术后4~6个月骨折愈合。末次随访时,患者均可弃拐行走,断端无疼痛感,X线片显示骨折端无移位、内固定无松动或折断;膝关节屈曲105°~120°,伸直0°~10°;采用New KSS评分系统评价膝关节功能:优14例,良12例,可3例,差1例,优良率26/30。结论单一切口双钢板治疗股骨远端粉碎性骨折,可达到骨折解剖复位、坚强固定效果,患者可进行早期功能锻炼,疗效满意。Objective To investigate the efficacy of double-plate with single-incision in the treatment of comminuted fracture of distal femur.Methods The 30 patients with comminuted fractures of distal femur were treated by double-plate with single-incision.Fracture reduction and healing situation,walking with weight-bearing,postoperative complications and knee range of motion were recorded.The New KSS scoring system was used to evaluate knee function.Results All patients were followed up for 6~24 months.No infection,limb shortening or rotation,joint subluxation occurred after surgery.Postoperative X-ray films showed that 28 cases of fractures had good alignment,the joint surfaces were flat,and anatomical reduction were achieved;2 cases had mild genu varus.Non-weight-bearing functional exercise of the affected limb on crutches began at 1~2 weeks after surgery,and gradually abandoned crutches and walked with weight-bearing after 4~6 months.Except 1 case was delayed healing at 12 months after surgery due to premature weight-bearing,the remaining patients healed in 4~6 months.At the last follow-up,all patients could abandon their crutches and walk without pain at the broken end.X-ray film showed no displacement of the fracture end,no loosening or breaking of internal fixation.Knee joint flexion was 105°~120°,extension was 0°~10°;knee joint function was evaluated by the New KSS scoring system:14 cases were excellent,12 cases were good,3 cases were fair,and 1 case poor,with an excellent-good rate of 26/30.Conclusions The treatment of comminuted fracture of distal femur fracture with single incision double-plate can achieve anatomic reduction and rigid fixation after operation,and the patients can carry out early functional exercise,with satisfactory curative effect.

关 键 词：股骨远端骨折 双钢板 单一切口 

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