股骨远端前外侧切口锁定钢板、前侧附加重建钢板在股骨远端Müller分型C2、C3型骨折治疗中的应用分析  

Application analysis of distal anterolateral incision locking plate and anterior lateral additional reconstruction plate in the treatment of C2 and C3 fractures in Müller classification of distal femur

作　　者：仲彪 吕书军 史少华 ZHONG Biao;LYU Shu-jun;SHI Shao-hua(Department of Orthopedics,Hai'an City People's Hospital,Hai'an Jiangsu 226600,China)

机构地区：[1]海安市人民医院骨科,江苏海安226600

出　　处：《临床和实验医学杂志》2024年第8期841-845,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省科学技术厅重点研发计划项目(编号:BE201900107)。

摘　　要：目的 探究股骨远端前外侧切口锁定钢板、前侧附加重建钢板在股骨远端Müller分型C2、C3型骨折治疗中的应用效果。方法 回顾性选取2018年3月至2022年6月在海安市人民医院接受治疗的120例股骨远端Müller分型C2、C3型骨折患者作为本研究的研究对象,按照治疗方法不同分为对照组和研究组,每组各60例。对照组患者接受前外侧切口锁定钢板治疗,研究组患者接受前外侧切口锁定钢板+前侧附加重建钢板治疗。门诊随访12个月,比较两组患者临床指标(手术时间、术中出血量、术中C型壁透视次数、术后下地康复时间、骨折愈合时间及骨折愈合率),治疗效果,膝关节功能,术后1、2、3、6个月的膝关节活动度,术后6个月患者的下肢最大伸膝肌力矩、最大内屈角及术后并发症发生情况。结果 两组手术时间、术中出血量、术中C型壁透视次数及骨折愈合率比较,差异均无统计学意义(P>0.05);研究组术后下地康复时间、骨折愈合时间分别为(4.89±0.98)周、(6.61±1.06)个月,均短于对照组[(6.04±1.55)周、(8.45±1.02)个月],差异均有统计学意义(P<0.05)。研究组的治疗优良率为91.67%,高于对照组(78.33%),差异有统计学意义(P<0.05)。术后6个月,两组膝关节功能比较,差异无统计学意义(P>0.05)。术后1、2个月,两组膝关节活动度比较,差异均无统计学意义(P>0.05);术后3、6个月,研究组患者的膝关节活动度分别为(103.56±2.38)°、(115.68±2.77)°,均高于对照组[(92.45±5.46)°、(95.88±3.49)°],差异均有统计学意义(P<0.05)。术后6个月,研究组在触底即时及支撑末期时最大伸膝肌力矩分别为(22.66±1.26)、(18.99±2.15) Nm,均高于对照组[(19.56±2.01)、(17.58±1.87) Nm],最大内屈角分别为(3.56±0.26)°、(6.55±0.51)°,均小于对照组[(4.55±0.31)°、(7.66±0.46)°],差异均有统计学意义(P<0.05)。两组随访期内并发症发生率比较,差异无统计学意义(P>0.05Objective To explore the application analysis of distal anterolateral incision locking plate and anterior additional reconstruction plate in the treatment of distal Müller classification C2 and C3 fractures of femur.Methods A total of 120 patients with Müller classification C2 and C3 fractures of distal femur treated in Hai'an City People's Hospital from March 2018 to June 2022 were retrospectively selected as the research objects of this study,and they were divided into the control group and the study group according to the treatment methods,60 patients in each group.Patients in the control group received anterolateral incision locking plate treatment,and patients in the study group received anterior additional reconstruction plates.Ontpatient follow-up was 12 months.The clinical indexes(operative time,intraoperative blood loss,intraoperative C-wall fluoroscopy frequency time,postoperative rehabilitation time,fracture healing time,and fracture healing rate),therapeutic effect,knee function,knee motion at 1,2,3 and 6 months after operation,maximum knee extensor moment,maximum internal flexion angle at 6 months after operation,and postoperative complications of the two groups were compared.Results There were no statistically significant differences in operative time,intraoperative blood loss,intraoperative C-wall fluoroscopy time and fracture healing rate between the two groups(P>0.05).The postoperative rehabilitation time and fracture healing time of the study group were(4.89±0.98) weeks,(6.61±1.06) months,respectively,which were shorter than those of the control group [(6.04±1.55) weeks,(8.45±1.02) months],the differences were statistically significant(P<0.05).The treatment excellent and good rate of the study group was 91.67%,which was higher than that of the control group(78.33%),the difference was statistically significant(P<0.05).There was no statistically significant difference in knee joint function between the two groups at 6 months after operation(P>0.05).There were no statistically significant dif

关 键 词：股骨骨折 前外侧切口锁定钢板 前侧附加重建钢板 Müller分型 

分 类 号：R687.3[医药卫生—骨科学]