股骨远端复杂骨折的手术治疗  

OPERATIVE TREATMENT OF COMPLICATED DISTAL FEMORAL FRACTURES

作　　者：王志强[1] 汪琦[1] 金立国[1] 胡平[1] 苏立新[1] 贾庆灵[1] 孙柏山[1] 陈长河[1] 

机构地区：[1]唐山市第二医院创伤科,河北唐山063000

出　　处：《中国修复重建外科杂志》2004年第1期12-14,共3页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：唐山市科委资助项目 (0 31 3460 1 A- 1 5)~~

摘　　要：目的　探讨股骨远端严重粉碎骨折有效治疗方法。　方法　在动物实验基础上 ,我们于 2 0 0 1年3月～ 2 0 0 2年 8月 ,应用 AO髁支持钢板及自行设计翼状解剖型钢板内固定与同种异体骨移植治疗股骨远端复杂骨折2 6例 ,均为 AO/ASIF分类中 33C3.3。采用 AO技术 ,术中平均植骨 4 6 g。　结果　术后 2 4例伤口 期愈合 ,2例伤口感染经换药愈合。2 4例 4～ 11个月达到骨性愈合 ,2例过早负重致固定失败而再次手术。随访 7～ 2 5个月 ,平均 14个月 ,根据 Shelbourne and Brueckmann膝关节功能评定标准 ,优 5例 ,良 18例 ,可 1例 ,差 2例 ,优良率为 88.5 %。　结论　翼状解剖型钢板远端螺钉孔为长椭圆形且有连续钉孔 ,适合于严重粉碎骨折 ;翼状解剖型钢板及髁支持钢板内固定与充分植骨是治疗股骨远端复杂骨折较理想的方法 ,同种异体骨可以取代自体髂骨植骨。Objective To explore an effective way for treating severe complicated distal femoral fractures. Methods Twenty-six patients with complicated distal femoral fracture who all belonged to 33C 3.3 type according to AOASIF classification, were treated with a lateral condylar buttress plate or self-desinged aliform anatomical plate, and operated on with allogeneic bone grafting. Results All cases were followed up for an average of 14 months (ranging 5-25 months). Twenty-four wounds were primary healing postoperatively, 2 wounds were infected and healed after dressing change. Twenty-four had bone healing after 4-11 months, 2 needed to operate again because of earlier weight-bearing resulting in fixation failure. According to shelbourne and Brueckmann score, the excellent and good rate was 88.46%. Conclusion The internal fixation for complicated distal femoral fracture by self-designed aliform anatomical plate and lateral condylar buttress plate with a great deal of allograft bone is an effective surgical method. As it has long oval holes and the holes are consecutive ,the aliform anatomical plate is more suitable for severe complicated fractures. At the same time, autogenous-ilium transplantation can be substituted by the allograft bone.

关 键 词：股骨远端复杂骨折 手术治疗 AO髁支持钢板 翼状解剖型钢板 同种异体骨移植 

分 类 号：R687[医药卫生—骨科学]