两种复位方式锁定加压钢板内固定治疗老年股骨远端骨折的疗效比较  

Comparing the clinical efficacy of two reduction methods with locking compression plates in the treatment of elderly distal femoral fractures

作　　者：潘汝南 唐承杰[1] 李峰 蒋柒 刘晶晶 贾军锋 PAN Ru-nan;TANG Cheng-jie;LI Feng;JIANG Qi;LIU Jing-jing;JIA Jun-feng(SectionⅡ,Dept of Geriatric Orthopaedics,Sichuan Orthopaedic Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]四川省骨科医院老年骨科2,四川成都610041

出　　处：《临床骨科杂志》2024年第5期712-716,共5页Journal of Clinical Orthopaedics

基　　金：四川省成都市卫生健康委员会医学科研课题(编号:2021473)。

摘　　要：目的 比较切开复位和闭合复位锁定加压钢板内固定治疗老年股骨远端骨折的疗效。方法 将72例老年股骨远端骨折患者按照复位方式不同分为切开复位组(采用切开复位锁定加压钢板内固定治疗,31例)和闭合复位组(采用闭合复位锁定加压钢板内固定治疗,41例)。比较两组围手术期指标、骨折愈合时间、术后并发症发生情况。采用HSS评分评价膝关节功能。结果 患者均获得随访,时间12~48个月。骨折复位时间、术中出血量、手术时间、骨折愈合时间闭合复位组均短(少)于切开复位组(P<0.01);术中透视次数闭合复位组多于切开复位组(P<0.01)。术后输血率、术后并发症发生率闭合复位组均低于切开复位组(P<0.01)。HSS评分优良率:术后3个月闭合复位组高于切开复位组(P<0.01);术后12个月两组比较差异无统计学意义(P>0.05)。结论 与切开复位相比,闭合复位锁定加压钢板内固定治疗老年股骨远端骨折,操作简单,具有手术时间短、骨折复位时间短、术中出血量少、术后并发症少的优势,更利于骨折愈合及早期膝关节功能的恢复。Objective To compare the efficacy of open reduction and closed reduction locking compression plate internal fixation in the treatment of elderly distal femoral fractures.Methods A total of 72 elderly patients with distal femoral fractures were divided into two groups based on the reduction methods:an open reduction group(treated with open reduction and internal fixation using locking compression plates,31 cases)and a closed reduction group(treated with closed reduction and internal fixation using locking compression plates,41 cases).The perioperative indicators,fracture healing time and incidence conditions of postoperative complications between two groups were compared.Knee joint function was evaluated using the HSS score.Results All patients were followed up for 12~48 months.The closed reduction group showed shorter time for fracture reduction,less intraoperative blood loss,shorter surgical duration,and faster fracture healing,compared with the open reduction group(P<0.01).The frequency of intraoperative fluoroscopy in the closed reduction group was higher than that in the open reduction group(P<0.01).The excellent-good rate of HSS score:after 3 months of surgery,the closed reduction group was higher than the open reduction group(P<0.01);there was no statistical difference between the two groups at 12 months after surgery(P>0.05).Conclusions Compared with open reduction,closed reduction with internal fixation using locking compression plates for the treatment of elderly distal femoral fractures offers the advantages of simplicity,shorter surgical duration,shorter time for fracture reduction,decreased intraoperative blood loss,and fewer postoperative complications,thus promoting earlier fracture healing and better early recovery of knee joint function.

关 键 词：股骨远端骨折 闭合复位 锁定加压钢板内固定 老年人 

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