股骨逆行髓内钉附加外侧锁定钢板与内外侧双钢板治疗AO/OTA 33C型股骨远端骨折的临床疗效对比研究  

Comparative study on the clinical efficacy of retrograde femoral intramedullary nail plus lateral locking plate and medial-lateral double plate in the treatment of AO/OTA 33C distal femoral fracture

作　　者：徐维臻 刘晖[1] 张金辉 熊远飞 张剑平 吴进[1] XU Wei-zhen;LIU Hui;ZHANG Jin-hui;XIONG Yuan-fei;ZHANG Jian-ping;WU Jin(Department of Orthopaedics,The 909th Hospital,Dongnan Hospital of Xiamen University,Zhangzhou,Fujian,363000,China)

机构地区：[1]第九〇九医院(厦门大学附属东南医院)骨科,福建省363000

出　　处：《中国骨与关节杂志》2025年第3期233-241,共9页Chinese Journal of Bone and Joint

摘　　要：目的比较股骨逆行髓内钉附加外侧锁定钢板与股骨内外侧双钢板治疗AO/OTA 33C型股骨远端骨折的临床疗效。方法回顾分析2017年6月至2022年12月在我院接受治疗的78例AO/OTA 33C型股骨远端骨折患者,其中股骨逆行髓内钉附加外侧锁定钢板治疗患者42例(钉板组),股骨内外侧双钢板治疗患者36例(双钢板组)。记录两组患者的手术时间、术中出血量、下床负重时间,骨折愈合时间、视觉模拟评分(visual analogue scale,VAS)、膝关节活动度(range of motion,ROM)、美国特种外科(Hospital for Special Surgery,HSS)评分和并发症等指标。结果两组手术时间、术中出血量、负重时间、骨折愈合时间比较差异无统计学意义(P>0.05);术后3个月和6个月,两组VAS评分、膝关节ROM、HSS评分比较差异均无统计学意义(P>0.05)。钉板组术后并发症5例:膝关节僵硬2例、肢体短缩1例、伤口感染2例。双钢板组术后并发症6例:膝关节僵硬1例、延迟愈合2例,伤口感染3例,并发症发生率两组差异无统计学意义(P>0.05)。结论联合固定已成为治疗AO/OTA 33C型股骨远端骨折的趋势,而股骨逆行髓内钉附加外侧锁定钢板和股骨内外侧双钢板固定均是治疗该类型骨折有效的方案,具有固定可靠、有利于快速康复、临床疗效好等优点。Objective To compare the clinical efficacy of retrograde femoral intramedullary nail with lateral locking plate and medial and lateral femoral double plate in the treatment of AO/OTA 33C distal femoral fracture.Methods From June 2017 to December 2022,78 cases of AO/OTA 33C distal femoral fractures treated in our hospital were analyzed retrospectively,including 42 cases of femoral retrograde intramedullary nail plus lateral locking plate(nail plate group)and 36 cases of femoral medial and lateral double plate(double plate group).The operation time,intraoperative blood loss,weight-bearing time,fracture healing time,visual analogue scale(VAS),range of motion(ROM),hospital for special surgery(HSS)and complications of the two groups were recorded.Results There was no significant difference in operation time,intraoperative blood loss,weight-bearing time and fracture healing time between nail plate group and double plate group(P>0.05).There was no significant difference in VAS score,knee joint range of motion and HSS score between nail plate group and double plate group at 3 and6 months after operation(P>0.05).There were 5 cases of postoperative complications in nail plate group:2 cases of knee joint stiffness,1 case of limb shortening and 2 cases of wound infection.There were 6 cases of postoperative complications in the double plate group:1 case of knee joint stiffness,2 cases of delayed healing and 3 cases of wound infection.There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions Combined fixation has become a trend in the treatment of AO/OTA 33C distal femoral fractures.Retrograde femoral intramedullary nail with lateral locking plate and medial-lateral double-plate fixation are both effective schemes for the treatment,which have the advantages of reliable fixation,rapid recovery andsatisfactory effects.

关 键 词：骨折固定术 内 内固定器 股骨骨折 

分 类 号：R683.4[医药卫生—骨科学]