摘要
目的 探讨如何根据股骨远端复杂骨折的不同类型选择适当的内固定方法 ,以达到最佳的治疗效果。 方法 回顾分析 1999年 1月～ 2 0 0 2年 6月 62例 64侧股骨远端复杂骨折手术治疗的临床资料。采用AO分类法 ,其中A型骨折 2 0例 2 1侧 ,C型骨折 42例 43侧 ;应用AO股骨髁支撑钢板 18例 19侧 ,髁支撑钢板与超高分子聚乙烯板互锁组合固定 2 0例 2 1侧 ,股骨逆行交锁髓内钉固定 2 4例 ,术后进行科学合理的康复治疗。 结果 62例骨折经术后 4～ 3 8个月随访 ,骨折均获愈合 ,愈合时间 10周～ 16个月 ,平均 4.2个月。按Kolmert和Wulff的评价标准 ,优 3 1侧 ,良 17侧 ,可 11侧 ,差 5侧 ,优良率为 75%。 结论 采用合理可靠的内固定方法治疗股骨远端复杂骨折 ,多数疗效满意。髁支撑钢板适用于股骨远端各型骨折 ;股骨逆行交锁髓内钉是治疗A型和C1型骨折的首选方法 ;钢板与聚乙烯板互锁组合固定是治疗C2和C3型骨折的有效方法 ,其设计合理、操作方便、固定可靠 。
Objective To explore different techniques for treat me nt of complicated distal femoral fractures in order to obtain the best curative effects. Methods A retrospective study was done on the cli nical data of 62 patients (64 sides) with complicated distal femoral fractures a dmitted to our hospital from January 1999 to June 2002. According to AO classifi cation: 20 cases (21 sides) belonged to type A and 42 (43 sides) to type C. The supporting steel of AO femoral condyles were applied in 18 cases (19 sides), loc ked double-plating (steel plate and polyethylene plate) in 20 (21 sides) and th e retrograde intramedullary nail in 24. All cases received scientific and ration al rehabilitative treatment post-operatively. Results The 4-38 months follow up showed that 62 cases go t fracture healing with average healing period of 4.2 months (from 10 weeks to 1 6 months). According to criteria of Kolmert and Wulff, 31 sides were excellent, 28 good but 5 poor with an excellence rate of 75%. Conclusions A majority of treatment results of complicate d distal femoral fractures are satisfactory through rational and reliable intern al fixation. The supporting steel plate is suitable for all distal femoral fract ures; and the retrograde intramedullary nail is the treatment of choice for type A and type C1 fractures. As for types C2 and C3 fractures, the locked double-p lating combined with polyethylene is more effective than the supporting steel pl ate or the retrograde intramedullary nail for it has advantages of reasonable de sign, convenient operation and firm fixation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2003年第11期669-672,共4页
Chinese Journal of Trauma
基金
广东省卫生厅科学技术研究基金资助项目(A1 998336)
关键词
股骨远端复杂骨折
治疗
外科手术
互锁双板
Femoral fractures
Fracture fixation, internal
Fr acture fixation, intramedullary
Treatment outcome
Locked double-plating
