摘要
目的 比较顺行髓内钉、逆行髓内钉及锁定加压钢板内固定治疗股骨远端骨折的疗效。方法 对2005年1月至2009年12月期间采用内固定治疗且获得随访的85例股骨远端骨折患者资料进行回顾性分析，男46例，女39例；年龄15-58岁，平均38．8岁。根据内固定方式不同分为3组：顺行髓内钉组（n=17）、逆行髓内钥。组（n=42）及锁定加压钢板组（n=26）。比较3组患者的手术时间、术中出血量、膝关节功能优良率及并发症发生率。结果85例患者术后获12-24个月（平均18个月）随访。陈1例患者出现骨折不愈合外，其余患者骨折均在6个月内获愈合。在于术时间和术中出血量方面，顺行髓内钉组、逆行髓内钉组均优于锁定加压钢板组，顺行髓内钉组优于逆行髓内钉组，差异均有统计学意义（P〈0．05）。顺行髓内钉组、逆行髓内钉组及锁定加压钢板组患者膝关节Kolment标准评定结果优良率分别为58，8％（10／17）、88．1％（37／42）、69．2％（18／26），逆行髓内钉组与顺行髓内钉组比较差异有统计学意义（P〈0．05）。顺行髓内钉组、逆行髓内钉组及锁定加压钢板组患者术后并发症发生率分别为11．8％（2／17）、9．5％（4／42）、7．7％（2／26），差异无统计学意义（P=1．000）。所有患者均未出现关节感染。结论 逆行髓内钉治疗股骨远端骨折具有定位准确、固定牢靠、手术时间短及术中出血量少等优点，术后疗效较顺行髓内钉和锁定加压钢板更满意。
Objective To compare anterograde intramedullary nailing （AIN）, retrograde in- tramedullary nailing （RIN） and loeking compression plating （I,CP） in tbe treatment of distal femoral fraetures. Methods The clinical data were reviewed of 85 patients with distal femoral fractures who had been treated in our department between January 2005 and December 2009. They were 46 males and 39 females, 15 to 58 years old （average, 38.8 years old） . According to the fixation they were divided into 3 groups： AIN （ n = 17）, RIN （n = 42） and LCP （n = 26）. They were compared in terms of operation time, bleeding volume, functional recovery of the knee and complications. Results They were followed tor 12 to 24 months （average, 18 months） . All patients obtained bone union within 6 months except one case of nonunion. In terms of operation time and bleeding volume, AIN aml RIN were significantly better than LCP, and A1N significantly better than RIN too （ P 〈 0.05）. The good to excellent tale of functional recovery was 58.8% （10/17） for AIN, 88. 1% （37/42） for RIN and 69.2% （18/26） for LCP： RIN was signifieantly superior to AIN （ P 〈 0. 05）. The rate of postoperative cmnplications was I 1.8% （2/1 7） for AIN , 9.5% （4/42） tor RIN and 7.7% （2/26） for LCP, with no signifieant belween-group difference（ P = 1. 000） . Conclusion RIN has advantages of aecurate alignment, rigid immobilization, shorter operation time, less hleeding volume, and better funetional recovery of the knee over AIN anti LCP in the treatment of distal femoral fractures.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2012年第11期950-953,共4页
Chinese Journal of Orthopaedic Trauma
关键词
股骨骨折
骨折围定术
内
骨钉
骨板
Femoral fractures
Fracture fixation, internal
Bone nails
Bone plates
