两种方法治疗股骨远端A型骨折的疗效比较  

Comparison of two methods for treatment of type A distal femoral fractures

作　　者：张成绩 邓杰林 王海虎 张群虎 蒋略韬 刘祥忠 倪进荣 ZHANG Cheng-ji;DENG Jie-lin;WANG Hai-hu;ZHANG Qun-hu;JIANG Lüe-tao;LIU Xiang-zhong;NI Jin-rong(Dept of Orthopaedics,the First People′s Hospital of Suqian City,Suqian,Jiangsu 223800,China)

机构地区：[1]宿迁市第一人民医院骨科,江苏宿迁223800

出　　处：《临床骨科杂志》2024年第4期561-565,共5页Journal of Clinical Orthopaedics

基　　金：江苏省宿迁市科技局科技计划项目(编号:K202001)。

摘　　要：目的比较股骨逆行髓内钉与双锁定钢板治疗股骨远端A型骨折的临床疗效。方法将36例股骨远端A型骨折患者根据手术方法不同分为股骨逆行髓内钉组(19例)与双锁定钢板组(17例)。比较两组手术情况、骨折复位质量、下地时间、部分负重时间、完全负重时间、骨痂形成时间、骨折愈合时间、术后并发症发生情况、膝关节活动度和膝关节功能。结果患者均获得随访,时间10~18个月。手术时间、切口长度、术中出血量、下地时间、部分负重时间、完全负重时间、术后3个月膝关节功能评分逆行髓内钉组均优于双锁定钢板组(P<0.05)。骨折复位质量、骨痂形成时间、骨折愈合时间、术后并发症发生率、术后膝关节活动度、术后6个月和末次随访时膝关节功能评分、末次随访时膝关节功能优良率两组比较差异均无统计学意义(P>0.05)。结论股骨逆行髓内钉与双锁定钢板治疗股骨远端A型骨折均可取得满意的治疗效果,逆行髓内钉有手术时间短、创伤小、术中出血少及下地时间、部分负重时间和完全负重时间早的优势。Objective To compare the clinical efficacy of femoral retrograde intramedullary nail and double locking plates in the treatment of type A distal femoral fractures.Methods The 36 patients with type A fractures of the distal femur were divided into retrograde intramedullary nail group(19 cases)and double locking plates group(17 cases),according to different operation methods.The following data were compared between two groups,including the surgical conditions,fracture reduction quality,time to stand on the ground,partial weight-bearing time,full weight-bearing time,callus formation time,fracture healing time,postoperative complications,postoperative knee joint range of motion and knee joint function.Results All patients were followed up,the time lasted for 10~18 months.The operation time,incision length,intraoperative bleeding,time to stand on the ground,partial weight-bearing time,full weight-bearing time,knee joint function score at 3 months after operation in the retrograde intramedullary nail group were superior to those of the double locking plate group(P<0.05).There were no statistical differences between the two groups in fracture reduction quality,callus formation time,fracture healing time,incidence rate of postoperative complications,postoperative knee joint range of motion,knee joint function scores at postoperative 6 months and the last follow-up,and the excellent-good rate of knee joint functional scores at the last follow-up(P>0.05).Conclusions Both femoral retrograde intramedullary nail and double locking plates have achieved satisfactory treatment results for type A fractures of the distal femur,and retrograde intramedullary nail treatment has advantages of shorter operation time,less trauma,less bleeding,and earlier time to walk with partial weight-bearing time and full weight-bearing time.

关 键 词：股骨远端骨折 股骨逆行髓内钉 锁定钢板 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]