摘要
目的比较外侧钢板与双钢板内固定治疗股骨远端C2、C3型骨折的临床疗效,探讨双钢板固定治疗股骨远端C2、C3型骨折的可行性和疗效优势。方法回顾性分析2012年1月至2017年6月手术治疗股骨远端C2、C3型骨折38例,其中17例采用膝关节正中切口双钢板固定,21例采用传统外侧钢板固定,患者术后均采用主动运动,并结合练习器辅助持续被动活动,以促进膝关节的功能恢复。依据Hohl临床评分标准比较两组股骨远端C2、C3型骨折患者术后6周、6个月的膝关节功能。结果术后随访10~36个月(平均20.5个月),依据Hohl标准对股骨远端C2、C3型骨折疗效进行临床评分,膝关节正中切口双钢板固定组的术后6周膝关节功能评定结果为:优12例,良3例,中1例,差1例;外侧钢板固定组为:优9例,良5例,中4例,差3例。两组的优良率分别为88.24%和66.67%,差异有统计学意义。膝关节正中切口双钢板固定组发生2例延迟愈合,外侧钢板固定组有4例延迟愈合,含1例骨不连经二次手术后愈合,两组均无骨关节感染及下肢深静脉血栓形成。结论膝关节正中切口双钢板固定法治疗股骨远端C2、C3型骨折能够解决单钢板固定偏心性固定不稳的问题,方法可行,内固定强度可靠,通过早期锻炼,相较单钢板固定在早期膝关节功能恢复方面更有优势,且并发症少。
Objective To compare the clinical efficacy of two different internal fixations between using steel plate laterally and using double plate for type C2 and type C3 distal femoral fractures, and discuss about the feasibility and advantages of double plate fixation in the treatment of subjects with type C2 and type C3 distal femoral fractures. Methods The clinical data of 38 surgery patients with type C2 and type C3 distal femoral fractures were analyzed retrospectively. Seventeen of them were using double-plate technique through median incision on the knee and 21 were using traditional internal fixation with steel plate on lateral aspect from January 2012 to June 2017. After operation, all patients were taking voluntary exercise and training their knee joints with continuous passive motion support at the same time. According to Hohl standards,the score criteria for the knee function, clinical curative effect for each patient with type C2 and type C3 distal femoral fractures in two groups was evaluated at 6 weeks and 6 months after operation. Results Follow-up period after operation varies from 10 months to 36 months, with an average of 20.5 months. The status of knee joint at 6 weeks was measured according to Hohl standards. In subjects with double plate fixation treatment, there were 12 excellent cases, 3 good cases, 1 fair case and 1 poor case, while in other subjects who were using steel plate laterally, there were 9 excellent cases, 5 good cases, 4 fair cases and 3 poor cases. The rates of good and excellent cases were 88.24% and 66.67% with significant difference between two groups. Two cases of delayed union for facture healing happened among subjects with double plate fixation and 4 cases of delayed union happened in subjects with steel plate laterally, including 1 case of nonunion, which was healed after the second operation. None of the patients got bone and joint infection or lower extremity deep venous thrombosis(LEDVT). Conclusion The results show that the idea of using double-plate technique through med
作者
王次金
石跃滨
郝鹏
曹云平
汲方圆
Wang Cijin;Shi Yuebin;Hao Peng;Cao Yunping;Ji Fangyuan(Ma'anshan Center Hospital,Ma'anshan Anhui,243000,China)
出处
《生物骨科材料与临床研究》
CAS
2020年第1期56-59,共4页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
股骨
C型骨折
双钢板
Femur
Type C fracture
Double plate
