经膝关节前方正中入路内固定与股骨远端外侧切口术治疗股骨远端C2、C3型骨折的临床效果  

Clinical effect of internal fixation through the anterior median approach of knee joint and lateral distal femoral incision in the treatment of C2,C3 type distal femoral fracture

作　　者：魏为 林杰 WEI Wei;LIN Jie(120 Emergency Station,Affiliated Hospital of Jianghan University(Wuhan Sixth Hospital),Wuhan Hubei 430015,China;Department of Emergency,Affiliated Hospital of Jianghan University(Wuhan Sixth Hospital),Wuhan Hubei 430015,China)

机构地区：[1]江汉大学附属医院(武汉市第六医院)120急救站,湖北武汉430015 [2]江汉大学附属医院(武汉市第六医院)急诊科,湖北武汉430015

出　　处：《临床和实验医学杂志》2025年第3期284-288,共5页Journal of Clinical and Experimental Medicine

基　　金：湖北省卫生健康委科研项目(编号:WJ2023M137)。

摘　　要：目的分析采用经膝关节前方正中入路内固定与股骨远端外侧切口术治疗股骨远端C2、C3型骨折患者的临床效果。方法回顾性选取2023年1月至2024年3月期间在江汉大学附属医院(武汉市第六医院)进行手术的40例股骨远端C2、C3型骨折患者作为研究对象,按不同手术将其分为对照组(n=17)、研究组(n=23)。对照组患者采用股骨远端外侧切口术,研究组患者采用经膝关节前方正中入路内固定手术。比较两组患者手术期间的各项指标(手时间、术后引流量、术中出血量、术中透视次数),手术前和手术后3、6个月的髋关节功能(Harris评分)、膝关节活动度、膝关节功能[美国特种外科医院(HSS)膝关节评分]、治疗效果和并发症发生情况。结果研究组手术时间为(131.79±15.67)min,长于对照组[(110.52±12.45)min],术后引流量、术中出血量、术中透视次数分别为(79.41±6.46)mL、(215.27±10.78)mL、(10.38±1.37)次,均低于对照组[(90.23±7.96)mL、(300.18±15.67)mL、(13.79±1.51)次],差异均有统计学意义(P<0.05)。手术后3、6个月,两组Harris评分均较手术前升高,且研究组的Harris评分分别为(50.24±4.89)、(73.45±7.11)分,均高于对照组[(42.33±4.24)、(60.13±6.27)分],差异均有统计学意义(P<0.05)。手术后3、6个月,两组膝关节活动度均较手术前升高,且研究组的膝关节活动度分别为(101.77±9.37)°、(106.96±10.25)°,均高于对照组[(93.45±7.85)°、(96.41±8.23)°],差异均有统计学意义(P<0.05)。手术后3、6个月,两组HSS评分均较手术前升高,且研究组HSS评分分别为(81.24±3.96)、(85.37±4.58)分,均高于对照组[(73.45±3.49)、(76.85±3.64)分],差异均有统计学意义(P<0.05)。触地时、支撑末期,研究组最大内驱角分别为(3.56±0.37)°、(6.33±0.67)°,均低于对照组[(4.89±0.51)°、(7.46±0.75)°],最大伸膝肌力矩分别为(23.31±5.63)、(18.74±1.96)Nm,均高于对照组[(18.46±4.25)、(15.25±1.78)Nm]Objective To analyze the clinical effect of internal fixation through the anterior median approach of knee joint and lateral distal femoral incision surgery in the treatment of C2,C3 type distal femoral fracture.Methods A total of 40 patients with type C2 and C3 distal femoral fractures who underwent surgery in the Affiliated Hospital of Jianghan University(Wuhan Sixth Hospital)from January 2023 to March 2024 were retrospectively selected as the research objects.They were divided into control group(n=17)and study group(n=23)according to different operations.The patients in the control group were treated with lateral distal femoral incision surgery,and the patients in the study group were treated with internal fixation through the median anterior approach of the knee joint.The indexes during operation(hand time,postoperative drainage volume,intraoperative blood loss,intraoperative fluoroscopy times),hip joint function(Harris score),knee joint activity,knee joint function[hospital for special surgery(HSS)knee score]before operation,3 and 6 months after operation,treatment effect and complications were compared between the two groups.Results The operation time of the study group was(131.79±15.67)min,which was longer than that of the control group[(110.52±12.45)min],the postoperative drainage volume,intraoperative blood loss,and intraoperative fluoroscopy times were(79.41±6.46)mL,(215.27±10.78)mL,(10.38±1.37)times,which were lower than those of the control group[(90.23±7.96)mL,(300.18±15.67)mL,(13.79±1.51)times],the differences were statistically significant(P<0.05).At 3 and 6 months after operation,the Harris scores of the two groups were higher than those before operation,and the Harris scores of the study group were(50.24±4.89)and(73.45±7.11)points,respectively,which were higher than those of the control group[(42.33±4.24)and(60.13±6.27)points],the differences were statistically significant(P<0.05).At 3 and 6 months after operation,the knee joint activity of the two groups was higher than that before o

关 键 词：经膝关节前方正中入路内固定 股骨远端外侧切口术 股骨远端C型骨折 髋关节功能 膝关节活动度 

分 类 号：R687.3[医药卫生—骨科学]